Journal Article

Prediction of iopromide reduction rates during haemodialysis using an <i>in vitro</i> dialysis system

Tomohisa Teraoka, Takao Sugai, Sunao Nakamura, Hiroyuki Hirasawa, Shigeto Oda, Hidetoshi Shiga, Mio Suga, Shinji Yamane, Hiroyuki Ishii, Shin-ichi Yamagata, Nobunori Satoh and Shiro Ueda

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 20, issue 4, pages 754-759
Published in print April 2005 | ISSN: 0931-0509
Published online February 2005 | e-ISSN: 1460-2385 | DOI: http://dx.doi.org/10.1093/ndt/gfh676
Prediction of iopromide reduction rates during haemodialysis using an in vitro dialysis system

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Background. In clinical studies, it has been difficult to evaluate the influence of haemodialysis (HD) parameters on HD clearance (CLHD) and reduction rate (RR) of non-ionic contrast medium during HD sessions. We therefore predicted clinical values of CLHD and RR of iopromide, a non-ionic contrast medium, from findings obtained from in vitro experiments, and confirmed that these predictive values were comparable with the actual values in clinical cases.

Methods. We developed a correlation equation for predicting CLHD on the basis of in vitro HD experiments by varying blood flow rates between 100 and 200 ml/min with a cuprammonium rayon dialyser (AM-SD-10H). Total body clearance of iopromide (CLPT) was estimated by the Cockroft–Gault equation. The volume of distribution (Vd) was obtained from the reported value. By using the HD and three pharmacokinetic parameters (CLHD, CLPT and Vd), we predicted CLHD and RR for seven patients undergoing HD after the administration of iopromide.

Results. In the in vitro study, the mean values (±SD) of iopromide clearance at blood flow rates of 100, 150 and 200 ml/min were 45.35 (2.54), 53.88 (6.46) and 57.61 (4.72) ml/min, respectively. There were highly significant correlations between clearance and blood flow rate (r = 0.975). Although the predicted CLHD showed a tendency towards underestimation, a good correlation was found. Predicted RR values were similar to observed values except for one case.

Conclusion. The in vitro model used in the present study provides pertinent information about CLHD and is helpful for predicting RR during HD in individual patients undergoing HD.

Keywords: drug removal; haemodialysis; iopromide; pharmacokinetics; radiocontrast media

Journal Article.  3369 words.  Illustrated.

Subjects: Nephrology

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