ReviewClinical kidney journal2026
Prescription of off-label medications in patients on dialysis: time to challenge contraindications?
Review in Clinical kidney journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Prescribing off-label medications for patients undergoing dialysis presents significant clinical challenges that require careful judgement to optimize the risk-benefit ratio. The altered pharmacokinetic profile in this population, characterized by impaired renal elimination, modified non-renal clearance pathways, and complex polypharmacy, has traditionally led to numerous contraindications, not solely due to concerns about drug accumulation but also to prevent serious adverse events. While established dosing protocols exist for certain drug classes, robust pharmacological data remain insufficient for many contemporary medications, leaving clinicians without evidence-based guidance for commonly prescribed authorized therapies in participants without significant chronic renal disease. The categorical off-label medication contraindications in haemodialysis warrants new reconsideration in the light of emerging evidence that has successfully challenged these constraints through well-designed clinical studies and real-world experiences. In this review, we aim to examine the evidence on selected examples of off-label medications previously deemed contraindicated that have been successfully evaluated in patients treated by dialysis, and explore emerging therapeutic agents. Finally, we discuss the clinical, research, methodological, and regulatory barriers that must be addressed to improve evidence-based prescribing in patients on dialysis.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.