Kidney disease is a common occurrence and alters how the body processes many drugs. Therefore, prescribers must consider the person’s renal function before prescribing medicines and may need to amend the dose of renally excreted drugs. At present, there is limited data regarding dose adjustment in renal impairment, so prescribers require knowledge of pharmacokinetics. Prescribers also need to understand how the kidneys process drugs when functioning normally to be able to predict how renal impairment may affect pharmacokinetics. This article offers practical guidance on prescribing for adults who have stable chronic kidney disease and do not meet the criteria for specialist assessment. It also explores important steps that prescribers can take to optimise medicines use in this population.