Figure 1. Renal excretion of drugs and metabolites.
(A) Urinary excretion profiles for prescription drugs. Data on the urinary recovery of 308 drugs was collected from published clinical mass balance studies. Light blue bars denote the renal recovery of unchanged parent drug. For approximately one-half of all analyzed compounds, renal excretion of the parent compound contributes significantly to the overall elimination (light blue bars, ≥10% urinary excretion of parent drug). Data on the total recovery of parent drug and metabolites (dark blue bars) show that renal elimination is an important pathway also for drugs that are metabolically converted, with more than 90% of all analyzed drugs being recovered in urine to a significant extent (dark blue bars, ≥10% urinary excretion of parent drug + metabolites). (B) Schematic illustration of key drug transporters expressed in renal proximal tubule epithelium. Cation transporters are on the left hand side and anion transporters on the right. The basolateral membrane facing the blood is nearest to the reader. The nephron is shown in the far left.