A review of the fundamental principles for personalized pharmacotherapy prescribing for patients with concurrent renal and cardiac failure: the hospital pharmacist’s perspective

Abstract

Renal impairment is a prevalent comorbidity associated with heart failure (HF). A diminished glomerular filtration rate (eGFR) correlates with an elevated risk of cardiovascular death. Conversely, renal impairment is a prevalent and critical prognostic indicator in individuals with heart failure. This review examines the fundamental principles for personalized pharmacotherapy in patients with concurrent renal and cardiac failure, with a focus on the hospital pharmacist's perspective. Renal and cardiac failure often coexist, creating complex therapeutic challenges due to altered pharmacokinetics and pharmacodynamics. Personalized pharmacotherapy aims to optimize drug selection, dosing, and monitoring, considering individual patient characteristics such as renal and cardiac function, comorbidities, and drug interactions. This review discusses the clinical implications of renal and cardiac dysfunction on drug metabolism and excretion, highlighting strategies for dose adjustments, risk management, and therapeutic monitoring. The role of hospital pharmacists in ensuring safe, effective, and individualized pharmacotherapy is emphasized, with recommendations for interdisciplinary collaboration to enhance patient outcomes.