In this episode, we explore the intricate relationship between renal function, pharmacology, and electrolyte balance—a vital concept for safe nursing practice. You’ll learn how impaired kidney function alters drug metabolism and increases the risk of toxicity, especially in patients with chronic kidney disease (CKD). We’ll identify common nephrotoxic agents, including select antibiotics and contrast media, and discuss preventive strategies such as hydration and the use of acetylcysteine to reduce contrast-induced nephrotoxicity (CIN). The episode also highlights key medication classes used in renal care, including ACE inhibitors and ARBs for kidney protection, diuretics for fluid management, and erythropoietin for anemia treatment. Finally, we’ll review nursing management of electrolyte imbalances—from acidosis and hyperphosphatemia to potassium and sodium disturbances—to ensure safe, evidence-based care for patients with renal impairment.