Diabetes mellitus (DM) is the leading cause of kidney failure in the United States, and controlling DM slows kidney failure. Thus, treatment of DM with antihyperglycemic medications is vital for patients with kidney disease. However, as kidney function and medication elimination decrease, patients are at increased risk for adverse drug reactions when medication doses are not adjusted appropriately. Dosing of antihyperglycemic medications for patients with kidney disease is an important issue for nurse practitioners and other health care providers. (C) 2018 Elsevier Inc. All rights reserved.