Which of the following phenomena contributes to the difficulties with absorption, distribution, and ...

Which of the following phenomena contributes to the difficulties with absorption, distribution, and elimination of drugs that are associated with kidney disease?
 
  A)
  Reductions in plasma proteins increase the amount of free drug and decrease the amount of protein-bound drug.
  B)
  Acute tubular necrosis is associated with impaired drug reabsorption through the tubular epithelium.
  C)
  Decreased retention by the kidneys often renders normal drug dosages ineffective.
  D)
  Dialysis removes active metabolites from circulation minimizing therapeutic effect.