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Elimination and clearance of pamidronate by haemodialysis (Brief Communication)
Author(s) -
BUTTAZZONI MIRENA,
ROSA DIEZ GUILLERMO J,
JAGER VICTOR,
CRUCELEGUI MARIA S,
ALGRANATI SALOMON L,
PLANTALECH LUISA
Publication year - 2006
Publication title -
nephrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 61
eISSN - 1440-1797
pISSN - 1320-5358
DOI - 10.1111/j.1440-1797.2006.00569.x
Subject(s) - medicine , urology , hemodialysis , dialysis , bisphosphonate , extracorporeal , end stage renal disease , renal function , surgery , anesthesia , osteoporosis
SUMMARY: Pamidronate (APD), a third‐generation bisphosphonate, has proven to be useful in haemodialysis (HD) patients with ectopic calcifications and hypercalcaemia. Little is known about bisphosphonates clearance in patients undergoing HD. The authors’ main objective was to study HD removal and clearance of APD. In total, 23 HD‐requiring anuric end‐stage renal disease (ESRD) adult individuals (12 men) aged 61.7 ± 13 (mean ± SD) years were admitted into the study. APD clearance and elimination were evaluated by 99m Technetium APD (half‐life 6 h). In total, 1 mg of labelled APD was injected via the arteriovenous graft prior to the start of HD. Blood samples were then drawn from the arterial (predialyser) and venous (postdialyser) lines of the extracorporeal circuit 2 h after the HD onset. In a subgroup of patients ( n : 15) the dialysate was collected and quantified during the three initial HD hours. Venous APD concentrations (postdialyser) were 72 + 7% of arterial (predialyser) concentrations. Mean APD clearance was 69.3 + 16.6 mL/min, and mean APD extraction during dialysis session was 31.6 + 10.1%. In the present study involving HD‐requiring anuric ESRD patients APD was successfully eliminated by HD. At the dose administered here none of the participants reported adverse events. APD is a potentially useful drug to be administered to HD‐requiring ESRD patients, the understanding of its removal during HD as well as its dialytic clearance allows for a safer management of a drug that is usually eliminated by renal excretion.