ABSTRACT
Glomerular filtrate contains concentrations of low-molecularweight solutes similar to plasma. In contrast, molecules with a molecular weight of 66 000 (including plasma proteins and drug-protein complexes) do not pass through the glomerulus. Accordingly, only free drug passes into the filtrate. Renal impairment (Chapter 7) predictably reduces the elimination of drugs that depend on glomerular filtration for their clearance (e.g. digoxin). Drugs that are highly bound to albumin or α-1 acid glycoprotein in plasma are not efficiently filtered.
