173PHARMACOTHERAPEUTIC MANAGEMENT IN CHRONIC KIDNEY DISEASE: RENAL DOSE ADJUSTMENT, DIALYSIS CONSIDERATIONS, AND PHARMACIST-LED CAREChronic kidney disease (CKD) is a progressive condition characterized by the deterioration of kidney function, thus causing the inability to excrete drugs and metabolites, alterations in fluid and electrolyte balance and predisposition of getting drug-related complications. Drug accumulation, toxicity, and treatment failure are avoided by careful adjustment of renal dosage depending on estimations of glomerular filtration rate or clearance of creatinine to ensure safe pharmacotherapeutic management in CKD. Dialysis also makes therapy complicated since some drugs can be eliminated partially based on their molecular weight, protein binding, volume of distribution, and dialysis modality. Hence, personalized dosage regimes and supplementation after the dialysis could be required. People with CKD frequently use lots of comorbidities making them prone to polypharmacy, which further exposes them to drug interactions and adverse effects. This is because pharmacists have a critical role in ensuring an optimal therapy by reviewing the medication, modifying the renal dose, avoiding the use of nephrotoxic drugs, monitoring electrolyte imbalance, enhancing adherence, and multidisciplinary care to support better clinical outcomes and medication safety.paritalasrikanth149@gmail.comResearch1622026Chronic kidney disease, Renal dose adjustment, Dialysis, Pharmacotherapeutic management, Pharmacist-led care.Srikanth P1*, Mohana Sindu S1, Komali K1, Kavya A1, Dr. Akila CRPharm.D Intern, Department of Pharmacy Practice, KLR Pharmacy College, Paloncha, Telangana, India.