Back to Search
Start Over
β -Blocker Dialyzability in Maintenance Hemodialysis Patients: A Randomized Clinical Trial.
- Source :
-
Clinical journal of the American Society of Nephrology : CJASN [Clin J Am Soc Nephrol] 2018 Apr 06; Vol. 13 (4), pp. 604-611. Date of Electronic Publication: 2018 Mar 08. - Publication Year :
- 2018
-
Abstract
- Background and Objectives: There is a paucity of data available to describe drug dialyzability. Of the available information, most was obtained before implementation of modern hemodialysis membranes. Our study characterized dialyzability of the most commonly prescribed β -blockers in patients undergoing high-flux hemodialysis.<br />Design, Setting, Participants, & Measurements: Patients on hemodialysis ( n =8) were recruited to an open label, pharmacokinetic, four-way crossover trial. Single doses of atenolol, metoprolol, bisoprolol, and carvedilol were administered on separate days in random order to each patient. Plasma and dialysate drug concentrations were measured, and dialyzability was determined by the recovery clearance and arterial venous difference methods.<br />Results: Using the recovery clearance method, the dialytic clearance values for atenolol, metoprolol, bisoprolol, and carvedilol were 72, 87, 44, and 0.2 ml/min, respectively ( P <0.001). Applying the arterial venous difference method, the dialytic clearance values of atenolol, metoprolol, bisoprolol, and carvedilol were 167, 114, 96, and 24 ml/min, respectively ( P <0.001).<br />Conclusions: Atenolol and metoprolol are extensively cleared by hemodialysis compared with the negligible dialytic clearance of carvedilol. Contrary to estimates of dialyzability on the basis of previous literature, our data indicate that bisoprolol is also dialyzable. This finding highlights the importance of conducting dialyzability studies to definitively characterize drug dialytic clearance.<br /> (Copyright © 2018 by the American Society of Nephrology.)
- Subjects :
- Adrenergic beta-Antagonists analysis
Adult
Aged
Aged, 80 and over
Atenolol blood
Atenolol pharmacokinetics
Bisoprolol blood
Bisoprolol pharmacokinetics
Carvedilol blood
Carvedilol pharmacokinetics
Cross-Over Studies
Female
Humans
Male
Metoprolol blood
Metoprolol pharmacokinetics
Middle Aged
Adrenergic beta-Antagonists blood
Adrenergic beta-Antagonists pharmacokinetics
Dialysis Solutions chemistry
Renal Dialysis
Subjects
Details
- Language :
- English
- ISSN :
- 1555-905X
- Volume :
- 13
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Clinical journal of the American Society of Nephrology : CJASN
- Publication Type :
- Academic Journal
- Accession number :
- 29519953
- Full Text :
- https://doi.org/10.2215/CJN.07470717