The physiology of the kidney has long been understood, and its mechanisms are well described. The pathology of renal failure is also a deeply researched area. It seems logical, therefore, to create devices that can replace the lost normal function of the kidney. Using the physical processes that take place in the kidney, such as diffusion or convection across a membrane, various renal replacement therapies (RRT) have been created. There are those that are used intermittently and those that are used for longer periods. What they have in common is that all RRTs have the same purpose; to replace the excretory function of the kidney that has been lost. CRRT is an extracorporeal renal replacement therapy that effectively replicates the excretory function of the kidneys in cases of acute renal failure. However, it has become increasingly evident that this rapidly advancing treatment modality offers benefits beyond merely substituting kidney function, with its applications continuing to expand significantly with non-renal and other indications. The use of these devices has raised new questions, many of which are still not clearly answered. When should this start? Who should receive it? How long should it last? What indication should it be for? What modality should it be with? How does it change the pharmacokinetics of the medicines? To answer these questions, it is first worth understanding the mechanisms behind the processes and the factors that influence them. This should not only focus on the procedures used in RRT therapies, but also consider the patient’s condition and the physicochemical properties of the drugs. In this review, we aim to provide a literature summary to highlight the factors that may influence the success of RRT therapies.
Publication Name: Basic and Clinical Pharmacology and Toxicology
Publication Date: 2025-10-01
Volume: 137
Issue: 4
Page Range: Unknown
Description:
The publication explores the development of the Augmented Medication Risk Score (AUGMERIS) calculator, a web application supported by artificial intelligence, designed to automate the evaluation of medication therapies with the Danish Medication Risk Score (MERIS) method. It is a tool that assesses drug combinations and kidney function in estimated glomerular filtration rate (eGFR), which helps clinical pharmacists identify high-risk patients. To overcome the problem of processing unstructured electronic health records (EHRs), a hybrid text processing model was created by combining rigorous algorithms and Generative Pre-trained Transformer (GPT) technology, which was integrated into a web application along with an automated risk calculation programme. Our objective was to develop and test a globally accessible calculator application with the validation of performance on poor-quality data. Despite the validation limitations, the text processing function serves the application satisfactorily. The AUGMERIS web app is built with Python 3 and shared globally by Streamlit. Volunteer testers from eight different countries performed a total of 383 trial calculations. The application has the potential to improve global pharmacotherapy by identifying patients requiring medication reviews. Its wider adoption might enhance patient safety and optimize treatments in a variety of healthcare systems.