It is the volume of the plasma or the blood that is completely cleared from the drug per unit time by the kidney. It has units of volume/time.

The renal clearance cannot exceed the CL_T. However it can be equal to the CL_T when the drug is excreted completely unchanged by the kidney.

The renal clearance can be determined from the renal excretion rate over a short interval and the average plasma concentration during this interval.

Renal clearance =

Renal excretion rate

Cp average

The total body clearance is the volume of the plasma or blood which is completely cleared from the drug per unit time. It has units of volume/time.

The CL_T for a drug is constant within a patient (dose and concentration independent) when the elimination processes follow first-order kinetics.

The total body clearance is a measure of the efficiency of all eliminating organs in eliminating the drug and it is the sum of all organ clearances (i.e. CL_T is the sum of the renal clearance, hepatic clearance and all other organ clearances).

The elimination rate constant and the half life (the dependent pharmacokinetic parameters) are dependent on (is determined from) the total body clearance and the volume of distribution (the independent pharmacokinetic parameters).

CLT

Vd = k and

CLT

Vd =

0.693

t 1/2

The first-order renal excretion rate constant is the rate constant for the drug elimination by the kidney. The renal excretion rate constant is dependent on the renal clearance and the volume of distribution.

CLR

Vd = k_e

This rate constant represents drug elimination by the kidney in the urine. The renal excretion rate constant cannot be bigger than the overall elimination rate constant (k). When the drug is excreted entirely through the kidney, the renal clearance will be equal to the CL_T and the renal excretion rate constant will be equal to the overall elimination rate constant.

The first-order renal excretion rate constant has units of time^-1.

The first-order elimination rate constant is the rate constant for the elimination of the drug from the body. The elimination rate constant and the half life are dependent on the total body clearance and the volume of distribution of the drug.

CLT

Vd = k =

0.693

t 1/2

This rate constant represents drug elimination through all routes of drug elimination such as metabolism, renal excretion, and other routes.

The first-order elimination rate constant has units of time^-1.