EDUCATIONAL REVIEW The role of genetics in drug dosing

Abstract Renal transplantation is the optimal form of renal replacement therapy (RRT) for the majority of patients. Both short- and long-term graft rejection are well recog-nized complications following transplantation, and optimal immunosuppression is often difficult to achieve. Pharmaco-dynamics (PD) and pharmacokinetics (PK) are hard to pre-dict in all patients, and best practice involves the use of standard dosing based on weight and therapeutic drug mon-itoring (TDM). Pharmacogenetics (PG) is the use of genetic screening to predict metabolic responses to different immu-nosuppressive drugs and enables more accurate predictions of PD and PK to be made. This has the potential to improve graft outcome by reducing both short- and long-term graft rejection