Pharmacokinetics of imidapril and its active metabolite imidaprilat following single dose and during steady state in patients with chronic renal failure

1998 ◽  
Vol 54 (1) ◽  
pp. 59-61 ◽  
Author(s):  
J. F. W. Hoogkamer ◽  
C. H. Kleinbloesem ◽  
A. Nokhodian ◽  
M. J. A. Ouwerkerk ◽  
G. Lankhaar ◽  
...  
Keyword(s):  
Renal Failure ◽  
Single Dose ◽  
Steady State ◽  
Chronic Renal Failure ◽  
Active Metabolite

scholarly journals Early effects of contrast media on renal hemodynamics and tubular function in chronic renal failure.

1995 ◽  
Vol 6 (5) ◽  
pp. 1451-1458
Author(s):  
D Russo ◽  
R Minutolo ◽  
B Cianciaruso ◽  
B Memoli ◽  
G Conte ◽  
...  
Keyword(s):  
Renal Failure ◽  
Single Dose ◽  
Chronic Renal Failure ◽  
Contrast Media ◽  
Fractional Excretion ◽  
Sodium Concentration ◽  
Renal Hemodynamics ◽  
Fractional Excretion Of Sodium ◽  
Urinary Levels ◽  
Renal Hypoperfusion

The pathophysiology and prevention of contrast media (CM)-induced nephropathy in chronic renal failure (CRF) are still ill defined. GFR, RPF, endothelin-1 (ET-1) levels, urinary sodium concentration, and fractional excretion of sodium were measured in CRF patients undergoing water diuresis in basal conditions and 20 to 120 min after an iv bolus of either the high-osmolar CM diatrizoate (D) or the low-osmolar CM iopamidol (I). The two CM induced an immediate and progressive decline of both GFR and RPF in the absence of hypovolemia, more pronounced in D (-36% at 120 min) than after I (-19% at 120 min; P < 0.05 versus D). Both CM determined a marked and steady increase of the fractional excretion of sodium. The natriuresis could not be totally ascribed to a CM-induced osmotic diuresis as because the urinary sodium concentration markedly increased. In two further groups of patients receiving D, we studied the effects of pretreatment with a single dose of either captopril or nifedipine. Both drugs, although not preventing the increase of natriuresis, partially antagonized D-induced renal hypoperfusion: GFR and RPF were equally reduced by 20% in D/captopril and D/nifedipine (P < 0.05 versus D). In unpretreated patients receiving either D or I, plasma ET-1 did not change but urinary levels increased; these changes were, however, dissociated from those observed in renal hemodynamics. Both plasma and urinary levels of ET-1 did not vary in pretreated groups. The 72-h follow-up evidenced a significant reduction of renal function only in the unpretreated D group. Therefore, the main findings after CM administration in CRF patients are: (1) an immediate GFR decline proportional to the osmolarity of CM and secondary to the renal hypoperfusion that is neither caused by hypovolemia nor mediated by ET-1, (2) an early tubular dysfunction at the level of the proximal nephron, and (3) a protective effect of single-dose pretreatment with either captopril or nifedipine on D-induced acute and short-term GFR changes.

The Importance of Age, Fludarabine and Total Body Irradiation in the Incidence and Severity of Chronic Renal Failure Following Allogeneic Hematopoietic Stem Cell Transplantation.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 2257-2257
Author(s):  
Julio Delgado ◽  
Nichola Cooper ◽  
Kirsty Thomson ◽  
Rafael Duarte ◽  
Panagiotis Kottaridis ◽  
...  
Keyword(s):  
Risk Factors ◽  
Renal Failure ◽  
Stem Cell ◽  
Single Dose ◽  
Chronic Renal Failure ◽  
Hematopoietic Stem Cell Transplantation ◽  
Dose Fractionation ◽  
High Dose ◽  
Hematopoietic Stem ◽  
Total Body

Abstract Nonmalignant late effects significantly impair the quality of life of long-term survivors following hematopoietic stem cell transplantation (HSCT), the major risk factors being chronic graft-versus-host disease (GVHD) and the use of total body irradiation (TBI) in the preparative regime. There has been a shift towards the use of fractionated, as opposed to single-dose TBI, in an attempt to reduce toxicity. Few reports exist on the renal consequences of HSCT, although many warn about the potential toxicity that eventually leads to chronic renal failure (CRF). However, the exact incidence of HSCT nephropathy is unknown, as there is a lack of well-designed analyses to provide cumulative incidence rates and descriptions of risk factors. The aim of this study was to assess retrospectively the risk and severity of CRF following TBI-based preparative regimes and the contribution of other patient, disease and post-transplant factors. From February 1996 to April 2004, 274 patients had TBI-based preparative regimes for allogeneic HSCT at our institution. Chemotherapy mainly consisted of cyclophosphamide (120 mg/kg) alone or in combination with fludarabine (90 mg/m2). TBI was started the day after completion of chemotherapy and was delivered as a single dose of 7.5 Gy (7.5S), 12 Gy in 6 fractions (12F), or 14.4 Gy in 8 fractions (14.4F). Fludarabine and high-dose TBI (14.4 Gy) were administered preferentially to those patients receiving T-cell depleted (TCD) grafts. GVHD prophylaxis was with a combination of cyclosporin (CSA) + methotrexate in unmanipulated transplants and with CSA alone or nothing in case of TCD grafts. CRF was defined as a persistent increase of serum creatinine (SCr) to greater than 120 μmol/l in males and 97 μmol/l in females (upper limits at our institution) over a period of at least six months. The cumulative incidence of CRF was 11% for the whole group. Renal tissue was available for review in 9 patients. All except one had histologic features suggestive of thrombotic microangiopathy ± radiation nephropathy. Kaplan-Meier analysis revealed a significant association between the incidence of CRF and older age at transplantation (>30 years; P = 0.0043), administration of fludarabine (P = 0.0014), high-dose/unfractionated TBI (14.4F > 7.5S > 12F; P = 0.0005) and TCD (P = 0.0031). Since fludarabine was usually associated to TCD grafts and high-dose TBI, we investigated whether the use of fludarabine was masking the effect of these other factors. Only older age at transplant (HR = 2.97; 95% CI, 1.32–6.68; P = 0.008) and fludarabine administration (HR = 3.22; 95% CI, 1.47–7.04; P = 0.003) remained significant in a multivariate Cox regression analysis. Of note, although TBI dose/fractionation did not fit in the multivariate model, CRF severity was significantly different as 38% of the patients in the 7.5S group currently require or have required permanent dialysis as opposed to 7% in both 12F and 14.4F groups combined. In conclusion, the incidence and severity of CRF post-transplant is associated with age, fludarabine administration and TBI dose/fractionation and, therefore, these factors should be kept in mind in order to prevent this late effect and devise new preparative regimens for HSCT.

Time Course of Gentamicin Serum Concentration Rebound following Hemodialysis

1987 ◽  
Vol 21 (1) ◽  
pp. 46-49 ◽  
Author(s):  
Marbel M. Catolico ◽  
Suzanne Campbell ◽  
William N. Jones ◽  
Joy L. Logan
Keyword(s):  
Renal Failure ◽  
Single Dose ◽  
Chronic Renal Failure ◽  
Serum Concentration ◽  
Time Course ◽  
Serum Concentrations ◽  
Serum Samples ◽  
Small Magnitude ◽  
Clinically Significant

The rebound in gentamicin serum concentration following hemodialysis was studied in six patients with chronic renal failure. The patients were not infected at the time of the study and received a single dose of gentamicin 2 mg/kg before hemodialysis. Serum samples were obtained immediately after dialysis and at 0.5, 1, 2, and 3 hours following hemodialysis. The average increases in gentamicin serum concentrations were 3.6 percent at 0.5 hour, 12.6 percent at 1 hour, and 6.6 percent at 2 hours. An average decline of 4.2 percent occurred at three hours. Only the increase seen at one hour was significantly different from the gentamicin serum concentration immediately following hemodialysis. This rebound was of small magnitude, though, and may not be clinically significant.

Metabolic clearance rate of arginine vasopressin in severe chronic renal failure

1992 ◽  
Vol 83 (5) ◽  
pp. 583-587 ◽  
Author(s):  
Nicholas B. Argent ◽  
Robert Wilkinson ◽  
Peter H. Baylis
Keyword(s):  
Renal Failure ◽  
Steady State ◽  
Chronic Renal Failure ◽  
Arginine Vasopressin ◽  
Clearance Rate ◽  
Plasma Concentrations ◽  
Normal Subjects ◽  
Metabolic Clearance ◽  
Metabolic Clearance Rate ◽  
Plasma Arginine

1. The metabolic clearance rate of arginine vasopressin was determined using a constant infusion technique in normal subjects and patients with chronic renal failure immediately before commencing dialysis. Endogenous arginine vasopressin was suppressed in all subjects before the infusion with a water load. 2. Plasma arginine vasopressin concentrations were determined using a sensitive and specific radioimmunoassay after Florisil extraction. The detection limit of the assay was 0.3 pmol/l, and intra- and inter-assay coefficients of variation at 2 pmol/l were 9.7% and 15.3%, respectively. 3. In normal subjects, the metabolic clearance rate was determined at two infusion rates producing steady-state concentrations of arginine vasopressin of 1.3 and 4.4 pmol/l. In the patients with renal failure, a single infusion rate was used, producing a steady-state concentration of 1.5 pmol/l. 4. At comparable plasma arginine vasopressin concentrations, metabolic clearance rate was significantly reduced in patients with renal failure (normal 1168 ± 235 ml/min versus renal failure 584 ± 169 ml/min; means ± sd; P<0.001). 5. Free water clearance was significantly reduced in normal subjects during the arginine vasopressin infusion from 8.19 ± 2.61 to −1.41 ± 0.51 ml/min (P<0.001), but was unchanged in the patients with renal failure after attaining comparable plasma arginine vasopressin concentrations. 6. In normal subjects there was a small but significant fall in metabolic clearance rate at the higher steady-state arginine vasopressin concentration (1168 ± 235 ml/min at 1.3 pmol/l versus 1059 ± 269 ml/min at 4.4 pmol/l; P = 0.016). 7. Our results show that the metabolic clearance rate of arginine vasopressin is reduced by approximately 50% in severe chronic renal failure. This alone may account for the raised plasma concentrations of the hormone seen in this condition.

Single-dose pharmacokinetics of 14C-lovastatin in chronic renal failure

1991 ◽  
Vol 50 (4) ◽  
pp. 437-441 ◽  
Author(s):  
Serge Quérin ◽  
Raymond Lambert ◽  
Jean R Cusson ◽  
Sylvie Grégoire ◽  
Stanley Vickers ◽  
...  
Keyword(s):  
Renal Failure ◽  
Single Dose ◽  
Chronic Renal Failure
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