S Tsuruoka1, K I Sugimoto, T Hayasaka, T Saito, A Fujimura. 1. Department of Clinical Pharmacology, Jichi Medical School, 3311-1 Yakushiji, Minamikawachi, Kawachi, Tochigi 329-0498, Japan. tsuru@jichi.ac.jp
Abstract
OBJECTIVE: To compare the effect of hemodialysis using two different types of dialyzer membranes, polysulfone (PS), a high-flux membrane, and cuprophane (CP), a conventional membrane, on blood ranitidine concentration. BACKGROUND: Recent advances in hemodialyzer membranes have improved the removal of small and middle size uremic toxins, while little is known about the change of drug removal by new membranes. METHODS: Eight patients with chronic renal failure who received ranitidine (150 mg/day) on a chronic basis were included. During the dialysis, blood samples were obtained from both the arterial and venous sides (before and after, respectively) of the dialyzer. RESULTS: Serum concentration of ranitidine decreased more on PS [54 +/- 3% (+/- SEM) reduction after 3 h] than on CP (35 +/- 4%). The dialyzer clearance of ranitidine on PS membrane (67.2 +/- 4.4 ml/min/m2) was significantly higher than that on CP (43.1 +/- 3.8 ml/min/m2, P < 0.001). Elimination fraction (EF) of the drug during the dialysis with PS was also significantly higher than that with CP (72 +/- 2% versus 44 +/- 3%). Apparent half-life of ranitidine during dialysis with PS (2.9 +/- 0.4 h) was shorter than that with CP (5.1 +/- 0.7 h). However, the amount of ranitidine removed by a single dialysis with PS membrane was less than 20 mg. CONCLUSION: Ranitidine clearance by hemodialysis is significantly higher with PS than with CP. Although additional dose adjustment may not be needed for ranitidine, the type of dialyzer membrane can affect drug elimination and should be taken into account for consideration of drug removal by hemodialysis.
OBJECTIVE: To compare the effect of hemodialysis using two different types of dialyzer membranes, polysulfone (PS), a high-flux membrane, and cuprophane (CP), a conventional membrane, on blood ranitidine concentration. BACKGROUND: Recent advances in hemodialyzer membranes have improved the removal of small and middle size uremic toxins, while little is known about the change of drug removal by new membranes. METHODS: Eight patients with chronic renal failure who received ranitidine (150 mg/day) on a chronic basis were included. During the dialysis, blood samples were obtained from both the arterial and venous sides (before and after, respectively) of the dialyzer. RESULTS: Serum concentration of ranitidine decreased more on PS [54 +/- 3% (+/- SEM) reduction after 3 h] than on CP (35 +/- 4%). The dialyzer clearance of ranitidine on PS membrane (67.2 +/- 4.4 ml/min/m2) was significantly higher than that on CP (43.1 +/- 3.8 ml/min/m2, P < 0.001). Elimination fraction (EF) of the drug during the dialysis with PS was also significantly higher than that with CP (72 +/- 2% versus 44 +/- 3%). Apparent half-life of ranitidine during dialysis with PS (2.9 +/- 0.4 h) was shorter than that with CP (5.1 +/- 0.7 h). However, the amount of ranitidine removed by a single dialysis with PS membrane was less than 20 mg. CONCLUSION:Ranitidine clearance by hemodialysis is significantly higher with PS than with CP. Although additional dose adjustment may not be needed for ranitidine, the type of dialyzer membrane can affect drug elimination and should be taken into account for consideration of drug removal by hemodialysis.