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Pharmaceutics
Special Issues
Optimizing Drug Therapy in Kidney Diseases: Effectiveness and Safety
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Optimizing Drug Therapy in Kidney Diseases: Effectiveness and Safety

A special issue of Pharmaceutics (ISSN 1999-4923). This special issue belongs to the section "Pharmacokinetics and Pharmacodynamics".

Deadline for manuscript submissions: 30 September 2025 | Viewed by 1031

Special Issue Editors

Dr. Pedro Dorado

E-Mail Website
Guest Editor
1. Department of Medical-Surgery Therapeutics, Pharmacology Section, Faculty of Medical and Health Sciences, University of Extremadura, Av. de Elvas s/n., 06071 Badajoz, Spain
2. Personalized Medicine and Mental Health Unit (MEPER), Extremadura Biosanitary University Research Institute of Extremadura (INUBE), Av. de Elvas s/n., 06080 Badajoz, Spain
Interests: pharmacogenetics; pharmacogenomics; clinical pharmacology; personalized and precision medicine; psychopharmacology; nephropharmacology
Dr. Miłosz Miedziaszczyk

E-Mail Website
Guest Editor
Department of Clinical Pharmacy and Biopharmacy, Poznan University of Medical Sciences, 60-806 Poznan, Poland
Interests: tacrolimus; drug–drug interactions; pharmacotherapy of kidney diseases; drug-induced nephrotoxicity; pharmacokinetics
Dr. Ilona Idasiak-Piechocka

E-Mail Website
Guest Editor
Department of General and Transplant Surgery, Poznan University of Medical Sciences, 60-355 Poznan, Poland
Interests: glomerulonephritis; kidney transplantation; immunosuppression; hemodialysis; peritoneal dialysis; vasculitis

Special Issue Information

Dear Colleagues,

It is known that diabetes, hypertension, or glomerulonephritis are the cause of chronic kidney disease (CKD), which is classified as a civilization disease. Therefore, research into new drugs for the treatment of kidney diseases is needed. In recent years, biological treatment, including monoclonal antibodies, has been a revolution in nephrology. Chronic kidney disease is associated with disorders of pharmacokinetic processes, mainly at the stage of distribution or excretion of drugs. It is important to appropriately modify the dosage of drugs depending on the filtration function of the kidneys in order to maintain a therapeutic drug concentration and the safety of pharmacotherapy. Patients treated with renal replacement therapy (hemodialysis, peritoneal dialysis) require supplementation of doses to support the effectiveness of treatment. Patients after kidney transplantation take immunosuppressive drugs; polypharmacy increases the risk of drug–drug interactions. One of the tools for optimizing pharmacotherapy is therapeutic drug monitoring, which plays a key role in the group of patients with chronic kidney disease.

We invite researchers studying pharmacokinetics, pharmacodynamics, and drug–drug interactions in patients with kidney diseases to submit original research articles or review articles. The purpose of this Special Issue is to provide both researchers and clinicians with up-to-date information.

Dr. Pedro Dorado
Dr. Miłosz Miedziaszczyk
Dr. Ilona Idasiak-Piechocka
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Pharmaceutics is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • drug–drug interactions
  • pharmacotherapy of kidney diseases
  • immunosuppression
  • drug-induced nephrotoxicity
  • glomerulonephritis
  • kidney transplantation
  • hemodialysis
  • peritoneal dialysis
  • vasculitis

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Published Papers (2 papers)

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Research

15 pages, 4231 KB  
Article
Randomized Clinical Trial for the Optimization of Dyslipidemia Management in Patients with End-Stage Renal Disease Undergoing In-Hospital Maintenance Hemodialysis Therapy
by Sadia Rehman, Muhammad Farhan, Muhammad Raza Sarfraz, Asma Naveed, Fahad Usman, Anila Bibi, Raheel Ahmed, Hiya Huq, Ali Hasan, Jarin Anzoom and Pobitro Kumar
Pharmaceutics 2025, 17(9), 1128; https://doi.org/10.3390/pharmaceutics17091128 (registering DOI) - 28 Aug 2025
Abstract
Background/Objectives: End-stage renal disease (ESRD) patients on maintenance hemodialysis (MHD) frequently develop L-carnitine (LC) deficiency, leading to dyslipidemia and increased cardiovascular risk. While LC supplementation may improve dyslipidemia, the optimal route of administration remains unclear. This study evaluates the effects of LC [...] Read more.
Background/Objectives: End-stage renal disease (ESRD) patients on maintenance hemodialysis (MHD) frequently develop L-carnitine (LC) deficiency, leading to dyslipidemia and increased cardiovascular risk. While LC supplementation may improve dyslipidemia, the optimal route of administration remains unclear. This study evaluates the effects of LC on dyslipidemia in MHD patients and compares oral versus intravenous (IV) administration. Methods: In this dual-center randomized controlled trial (NCT05817799), 102 MHD patients aged 18–50 years were randomized to receive either oral (500 mg thrice daily) or IV LC (20 mg/kg post-dialysis thrice weekly for 23 weeks followed by 500 mg oral daily for 1 week) for 24 weeks, and blood samples were obtained to evaluate lipid profile parameters. Results: Eighty-three patients completed the study (oral n = 49, IV n = 34). Both groups demonstrated significant improvements in all lipid parameters (p < 0.0001). In the oral group, total cholesterol (TC) demonstrated a mean reduction of 15.04 ± 8.52, triglycerides (TG) decreased by 14.84 ± 13.20, and low-density lipoprotein cholesterol (LDL-C) declined by 9.87 ± 8.74, with a rise in high-density lipoprotein (HDL) of 5.34 ± 4.33. In contrast, the IV group showed greater improvement, with TC being reduced by 17.62 ± 8.98, TG reduced by 19.21 ± 11.33, and HDL-C elevated by 7.26 ± 4.35. Group comparison revealed significantly greater LDL reduction in the IV group (71.91 ± 14.37 mg/dL) versus oral group (79.04 ± 14.92 mg/dL, p = 0.03), whereas TC, TG, and HDL changes showed no significant differences (p > 0.05). Conclusions: Both oral and IV interventions effectively improved lipid profiles, and IV administration showed a more pronounced effect on LDL reduction, suggesting potentially greater efficacy of IV administration for LDL reduction. Full article
(This article belongs to the Special Issue Optimizing Drug Therapy in Kidney Diseases: Effectiveness and Safety)
12 pages, 1498 KB  
Article
Long-Term Effect of Semaglutide on the Glomerular Filtration Rate Slope in High-Risk Patients with Diabetic Nephropathy: Analysis in Real-World Clinical Practice
by Enrique Luna, Álvaro Álvarez, Jorge Rodriguez-Sabiñón, Juan Villa, Teresa Giraldo, Maria Victoria Martín, Eva Vázquez, Noemi Fernández, Belén Ruiz, Guadalupe Garcia-Pino, Coral Martínez, Lilia Azevedo, Rosa María Diaz, Nicolas Roberto Robles and Guillermo Gervasini
Pharmaceutics 2025, 17(7), 943; https://doi.org/10.3390/pharmaceutics17070943 - 21 Jul 2025
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Abstract
Background: Semaglutide, a GLP-1 receptor agonist, has shown promising nephroprotective effects in clinical trials, though real-world data on its long-term impact on renal function in high-risk diabetic nephropathy patients remain scarce. Methods: We conducted a multicenter, retrospective observational study involving 156 patients with [...] Read more.
Background: Semaglutide, a GLP-1 receptor agonist, has shown promising nephroprotective effects in clinical trials, though real-world data on its long-term impact on renal function in high-risk diabetic nephropathy patients remain scarce. Methods: We conducted a multicenter, retrospective observational study involving 156 patients with type 2 diabetes and chronic kidney disease (CKD) treated with subcutaneous semaglutide between 2019 and 2023. Inclusion required an eGFR > 15 mL/min/1.73 m2 or albuminuria > 30 mg/g and at least two years of follow-up. The primary outcome was the change in eGFR slope after semaglutide initiation. Subgroup analyses were performed based on baseline eGFR, albuminuria, and SGLT2i co-treatment. Results: In the whole study population, the median eGFR slope significantly improved from −3.29 (IQR 7.54) to −0.79 (IQR 6.01) mL/min/1.73 m2/year post-treatment (p < 0.001). Multiple linear regression showed a hazard ratio for the effect of semaglutide on the eGFR slope of 4.06 (2.43–5.68), p < 0.001. In patients with baseline eGFR < 60 mL/min/1.73 m2, the slope improved from −3.77 to −1.01 (p < 0.0001), while patients on concurrent SGLT2i therapy saw slope changes from −2.96 to −0.37 (p < 0.0001). Patients with albuminuria 30–1000 mg/g also improved from −2.96 to −0.04 (p < 0.0001); however, those > 1000 mg/g did not show a significant change (p = 0.184). Semaglutide also reduced BMI (p = 0.04), HbA1c (p = 0.002), triglycerides (p = 0.001), CRP (p = 0.003), and GGT values (p = 0.004). Conclusions: In real-world practice, semaglutide significantly attenuated renal function decline in high-risk diabetic patients, particularly those with advanced CKD or concurrent SGLT2i therapy. These findings support its nephroprotective role beyond glycemic control. Full article
(This article belongs to the Special Issue Optimizing Drug Therapy in Kidney Diseases: Effectiveness and Safety)
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