This article examines renal drug elimination as a critical determinant of pharmacokinetic safety. It reviews glomerular filtration, tubular secretion, tubular reabsorption, renal clearance, estimation of kidney function and nephrotoxicity risk. Results show that renal impairment changes both drug exposure and adverse effect risk. The article argues that dose individualization must be understood as a safety framework rather than a mechanical arithmetic procedure.

renal clearance, drug elimination, kidney function, nephrotoxicity, pharmacokinetics, CKD

Azizova S.S. Farmakologiya. Toshkent: Abu Ali ibn Sino nomidagi tibbiyot nashriyoti, 1994.

Mavlyanov I.R., Mahkamova R.K., Kats P. Klinik farmakologiya. Toshkent: tibbiyot oliy ta’lim muassasalari uchun darslik.

Mamadov Yu.M. Klinik farmakologiya. Toshkent, 2010.

Gadayev A.G. Ichki kasalliklar propedevtikasi. Toshkent, 2018.

KDIGO CKD Work Group. KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney International, 2024.

Awdishu L. et al. KDIGO 2024 clinical practice guideline update. Kidney International Reports/PMC, 2025.

Mark P.B. et al. Global, regional, and national burden of chronic kidney disease in 2023. The Lancet, 2025.

Susa S.T. et al. Drug Metabolism. StatPearls/NCBI Bookshelf, 2023.

Mirkov S. et al. Estimation of kidney function for medication dosing in adult patients. Journal of Pharmacy Practice and Research, 2024.

International Society of Nephrology. Global Kidney Health Atlas, 2023.