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Titolo:
Effect of renal disease and hemodialysis on foscarnet pharmacokinetics anddosing recommendations
Autore:
Aweeka, FT; Jacobson, MA; Martin-Munley, S; Hedman, A; Schoenfeld, P; Omachi, R; Tsunoda, S; Gambertoglio, JG;
Indirizzi:
Univ Calif San Francisco, Dept Clin Pharm, San Francisco, CA 94143 USA Univ Calif San Francisco San Francisco CA USA 94143 ancisco, CA 94143 USA Univ Calif San Francisco, Dept Med, San Francisco, CA 94143 USA Univ CalifSan Francisco San Francisco CA USA 94143 ancisco, CA 94143 USA Astra USA, Westborough, MA USA Astra USA Westborough MA USAAstra USA, Westborough, MA USA Astra Arcus, Sodertalje, Sweden Astra Arcus Sodertalje SwedenAstra Arcus, Sodertalje, Sweden Northeastern Univ, Boston, MA 02115 USA Northeastern Univ Boston MA USA 02115 heastern Univ, Boston, MA 02115 USA
Titolo Testata:
JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES AND HUMAN RETROVIROLOGY
fascicolo: 4, volume: 20, anno: 1999,
pagine: 350 - 357
SICI:
1525-4135(19990401)20:4<350:EORDAH>2.0.ZU;2-3
Fonte:
ISI
Lingua:
ENG
Soggetto:
HUMAN IMMUNODEFICIENCY VIRUS; CYTOMEGALOVIRUS RETINITIS; LIQUID-CHROMATOGRAPHY; GENTAMICIN CLEARANCE; AIDS; THERAPY; PLASMA;
Keywords:
foscarnet; kidney; dialysis; dosing; pharmacokinetics;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
25
Recensione:
Indirizzi per estratti:
Indirizzo: Aweeka, FT UnivSAalif San Francisco, Dept Clin Pharm, C-152, San Francisco, CA 94143 U Univ Calif San Francisco C-152 San Francisco CA USA 94143 143 U
Citazione:
F.T. Aweeka et al., "Effect of renal disease and hemodialysis on foscarnet pharmacokinetics anddosing recommendations", J ACQ IMM D, 20(4), 1999, pp. 350-357

Abstract

Background: Foscarnet is an antiviral agent commonly used for managing patients with cytomegalovirus infection. Despite its clinical usefulness, foscarnet is associated with substantial adverse effects including nephrotoxicity, Moreover, foscarnet is primarily eliminated unchanged through the kidneys, thus requiring aggressive dose adjustment during kidney failure. To develop specific dosage guidelines, information on the disposition of this compound in patients with varying degrees of renal function and those requiring dialysis is essential. Design: Twenty-six subjects were enrolled in this study and divided into five groups depending on their degree of renal dysfunction, Group I includedsubjects with normal renal function; group 5 included subjects requiring maintenance hemodialysis. Nondialysis study subjects received a single 60-mg/kg intravenous dose of foscarnet whereas hemodialysis subjects received two intravenous doses, separated by I week, to compare the effects of conventional and high-flux dialysis methods. Results: Mean plasma clearance in control subjects averaged 2.1 +/- 0.7 ml/minute/kg and declined proportionally with changing renal function as indicated by the regression equation:Clp (ml/minute/kg) = 1.48 [CrCl (ml/minute/kg)] - 0.08 (r2 = 0.82)Mean half-life averaged 1.9 +/- 0.1 hours in normal subjects and increasedto a mean of 25 +/- 19 hours in study subjects with severe impairment not on dialysis. Foscarnet dialysis clearance (based on dialysate recovery) averaged 183 ml/minute with conventional dialysis methods and 253 ml/minute during high-nux procedures, which resulted in removal of 37% and 38% of a dose for the two methods, respectively. Conclusions: These data indicate that substantial dosage adjustments must be made in renal failure patients. Therefore, a patient-specific dosage nomogram has been developed.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 28/11/20 alle ore 21:31:34