Kinetics hemodialysis

After dialysis, often a rebound is seen in concentrations since elimination from plasma is faster than drug flux from tissue to plasma (Crebound — Ctissue - C). The concentration in plasma follows a bi-exponential kinetics during hemodialysis whereas the concentration in tissue follows mono-exponential kinetics. 

Kovalchik MT, Kaehny WD, Hegg AP, etal. 1978. Aluminum kinetics during hemodialysis. J Lab Clin Med 92 712-720. 

Nonrenal clearance is usually equated with drug metabolism, but also could include hemodialysis and other methods of drug removal. In fact, even the metabolic clearance of a drug frequently consists of additive contributions from several parallel metabolic pathways. The characterization of drug metabolism by a clearance term usually is appropriate, since the metabolism of most drugs can be described by first-order kinetics within the range of therapeutic drug concentrations. 

In a study of NAPA hemodialysis kineticS/ blood flow measured through the dialyzer averaged 195 mL/min (12). When evaluated by paired t test this was significantly less than Qpk, which averaged 223 mL/min. However/ Qpk was similar to estimates of Qeff, which averaged 217 mL/min. In this case... 

Ti T-Y, Fortin L, Kreeft JH, East DS, Ogilvie RI, Somerville PJ. Kinetic disposition of intravenous ceftriaxone in normal subjects and patients with renal failure on hemodialysis or peritoneal dialysis. Antimicrob Agents Chemother 1984 25 83-7. 

In patients undergoing chronic hemodialysis, the safety profile did not differ from that reported in other populations, except for some rare cases of hypotension during hemodialysis. Hemodialysis does not affect the kinetics of candesartan. Because of the variability of oral clearance and the pronounced influence of hemodialysis-induced volume contraction on the hemodynamic effects of candesartan, careful monitoring is recommended (2). 

Moreau C, Kerns II W,Tomaszewski CA, McMartin KE, Rose SR, Ford MD, Brent J, and the META study group. Glycolate kinetics and hemodialysis clearance in ethylene glycol poisoning. Clin Toxicol 1998 36 659-666. 

Pregnancy Pharmaco-kinetic category C Absorbed from the GI tract metabolized in the liver excreted in urine. Crosses the blood-brain barrier and the placenta and is found in breast milk PB 93% not removed by hemodialysis... 

Gotch F. Urea kinetics modelling to guide hemodialysis therapy in adults. In Nissenson AR, Fine RN, eds. Dialysis therapy. Philadelphia Hanley and Belfus, 2002 117-21. 

Daugirdas JT, KjellstrandCM. Chronic hemodialysis prescription A urea kinetic approach. In Daugirdas JT, Blake PG, Ing TS, eds. Handbook of Dialysis. Philadelphia, Lippincott Williams Wilkins, 2001 121-147. 

Krachler M, Scharfetter H, Wimsberger GH. 2000. Kinetics of the metal cations magnesium, calcium, copper, zinc, strontium, barium, and lead in chronic hemodialysis patients. Clin Nephrol 54(l) 35-44. 

Sauder P, Livardjani F, Jaeger A, Kopeersch-MiTT J, Heimburger R, Waller C, Mantz JM and Leroy M (1988) Acute mercury chloride intoxication. Effects of hemodialysis and plasma exchange on mercury kinetic. J Toxicol Clin Toxicol 26 189-197. 

Spalding, E. M., Chanmey, P. W., and Farrington, K. (2002). Phosphate kinetics during hemodialysis Evidence for biphasic regulation. Kidney Int. 61, 655. 

Keshaviah PR, Nolph KD, Van Stone JC.1989. The peak concentration hypothesis A urea kinetic approach to comparing the adequacy of continuous ambulatory peritoneal dialysis (CAPD) and hemodialysis. 

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