Clinical use of drugs is inevitable. However, a patient with chronic kidney disease must pay attention to his or her renal function status, as different renal function states have different abilities to excrete drugs, and patients with poor renal function may experience adverse effects from the accumulation of even normal doses of drugs in the body. In any case, patients with chronic kidney disease should keep in mind their own glomerular filtration rate (eGFR) values to ensure that they choose the drug that has the least impact on their kidneys. This article will help people with chronic kidney disease to have some knowledge about daily medication use. Many patients with chronic kidney disease (CKD) have no obvious clinical symptoms and are unaware of them. Since KDOQI’s CKD clinical practice guidelines have been widely disseminated and consistently accepted worldwide, more clinical laboratories will report assessed glomerular filtration rate (eGFR) and more clinicians and patients are aware of the prevalence of decreased kidney function. Decreased renal function can lead to a greater susceptibility to side effects and toxicity due to the accumulation of drugs metabolized in the kidneys. Toxicity includes damage to the kidney itself and damage to other systems. Medication safety focuses on maximizing efficacy and minimizing toxicity and maximizing the risk-benefit ratio. Everyone should know their level of kidney function and tell their doctor and pharmacist at the time of their visit and medication purchase to assist them in determining their medication regimen. Clinicians need to know the exact eGFR of a patient with CKD before giving him or her a treatment plan, and record all prescribed medications, over-the-counter medications, dietary supplements, and special foods that the patient uses. If new drugs are added to the regimen, it is important to have information on the pharmacokinetics of the new drugs, adjust doses, and monitor efficacy and adverse effects. Clinicians should try to select prescription drugs with less drug metabolism and shorter half-life (e.g., glipizide instead of glibenclamide, lorazepam instead of diazepam). Five major categories of common drugs that require dose adjustment in renal insufficiency: 1. lipid-regulating drugs: statins, beta lipid-regulating drugs; 2. analgesics: anti-inflammatory analgesics of the NSAIDs class, narcotic analgesics; 3. antibiotics: many antimycotics, antibacterial drugs, antivirals; 4. hypoglycemic drugs: insulin and certain hypoglycemic drugs; 5. gastric motility drugs, acidophilus: these drugs can lead to blood electrolyte disturbances. Clinicians also need to pay attention when using diagnostic drugs. Contrast agents often used in imaging departments can cause contrast nephropathy, the incidence of which is significantly higher in patients with CKD than in the general population, and also increases when combined with high-risk factors such as hypotension, chronic heart failure, diabetes, advanced age, and anemia. In addition, some intestinal preparation drugs contain high concentrations of magnesium or phosphorus, which can cause toxic reactions through intestinal absorption. Patients with CKD need to choose carefully when purchasing over-the-counter medications from pharmacies. For example, non-steroidal anti-inflammatory and analgesic drugs (NSAIDs) have been shown to decrease renal perfusion and worsen renal function. However, many compounded medications sold in pharmacies (e.g., compounded antipyretics, compounded pain relievers, compounded sleep aids) may contain NSAIDs, and it is difficult for patients to distinguish whether those complex chemical names are NSAIDs when they are purchased. Some patients don’t even understand that these are drugs, so they don’t consult their doctors or pharmacists to see if they can be used. Patients with CKD are also at risk when buying special foods and dietary supplements in supermarkets and health food stores. These products are not as strictly regulated as drugs, and the actual ingredients of some things may not match the ingredients stated on the label and may contain unsafe ingredients. In any case, patients should keep their eGFR numbers in mind, keep a complete record of the medications and special foods and dietary supplements they use, keep their records up to date, and ask about the risks associated with them when they are seen to ensure minimal impact on their kidneys. Try to fix the consultation doctor and pharmacy so that doctors and pharmacists can identify drug interactions early and make adjustments. Of course, it is also important to adhere to regular follow-up appointments and blood tests. Drug companies and government agencies should also emphasize the safety of drug use in patients with CKD when developing, approving and regulating marketed drugs and develop drug dose adjustment programs to reduce drug toxicity. Research on drug safety is urgently needed. In particular, the relationship between drug metabolism and therapeutic response and eGFR needs to be evaluated to determine the optimal risk-benefit ratio of drugs and to further guide drug dosing. There is also a need to study the incidence of drug-related problems in the CKD patient population and to quantify the clinical, economic, and prognostic impact, and to agree on safety indicators and definitions of criteria for medication use in CKD patients. In conclusion, the improvement of medication safety for CKD patients depends on the full attention and effective communication between doctors, patients, and enterprises, and on the government’s formulation of effective public health policies and leading creative systematic research.