Renal Drug Dosing Summary

How to use it

1. 1

   Select drug class and eGFR. Always verify the specific product SPC or BNF for exact dose adjustment.

2. 2

   Critical thresholds. Metformin stop <30. NSAIDs avoid <30. SGLT-2i avoid <20 (some class effects differ).

3. 3

   Use Cockcroft-Gault for DOACs. DOAC SPCs reference Cockcroft-Gault CrCl, not eGFR CKD-EPI.

When to use it

Medication review in CKD patients

Prescribing optimisation — most important in CKD G3b–G5.

AKI

Nephrotoxins (NSAIDs, aminoglycosides, contrast) should be stopped/avoided in AKI.

Polypharmacy

Regular structured medication review (≥75 yo or ≥10 drugs): eGFR-check all renally-cleared drugs.