D. Blowey, J. Leeder
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The prescription of a safe and effective dose of a medication for a child receiving dialysis is an arduous task as both renal failure and dialysis can modify the absorption, distribution, metabolism, elimination, and action of a drug. A safe and effective dosing regimen is one that delivers the appropriate drug in the optimal manner, producing the desired pharmacological response while minimizing the undesirable effects. Achieving the goal of successful drug therapy requires a clear understanding of the therapeutic goal coupled with an appreciation of the factors governing drug disposition and action. Failure to clearly identify the therapeutic goal or to account for the changes in drug disposition associated with renal failure and the performance of dialysis can culminate in drug toxicity or inadequate treatment.