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  • 1
    Electronic Resource
    Electronic Resource
    Pharmacokinetics of ranitidine in patients undergoing haemofiltration (1988)
    Springer
    European journal of clinical pharmacology 35 (1988), S. 427-430 
    Details
    ISSN: 1432-1041
    Keywords: ranitidine ; haemofiltration ; renal failure ; pharmacokinetics
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary The pharmacokinetics of ranitidine was investigated in 11 patients with acute or end stage renal failure during haemofiltration. Each patient received 50 mg ranitidine i.v. The mean distribution and elimination half lives were 0.13 and 2.57 h, respectively. The total body clearance (CL) and volume of distribution (Vz) were 298 ml·min−1 (5.19 ml·min−1·kg−1) and 1.081·kg−1, respectively. About 17.1% of the administered dose was removed by haemofiltration (in approximately 201 filtrate). Five of the patients still had some urine output and they excreted 0.1 to 11.8% of the dose in urine in 24 h. The haemofiltration clearance was 66.9 ml·min−1 at a filtrate flow rate of 86 ml·min−1, corresponding to a mean sieving coefficient of 0.78 (n=6). As plasma concentrations were still in an effective range after haemofiltration, dose supplementation is not recommended.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00561377
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  • 2
    Electronic Resource
    Electronic Resource
    Tripotassium dicitrato bismuthate: absorption and urinary excretion of bismuth in patients with normal and impaired renal function (1991)
    Oxford, UK : Blackwell Publishing Ltd
    Alimentary pharmacology & therapeutics 5 (1991), S. 0 
    Details
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: We have investigated the absorption and urinary excretion of tripotassium dicitrato bismuthate during a treatment course of 4 weeks in 7 patients with normal renal function (creatinine clearance 115 ± 29 ml/min; mean ± S. D.), in 7 patients with impaired renal function (creatinine clearance = 34 ± 19 ml/min) and in 4 dialysed patients. Following the first dose of tripotassium dicitrato bismuthate (216 mg bismuth b.d.), and after 2 and 4 weeks of treatment (dialysed patients received only 108 mg/b.d.), plasma and urine concentrations of bismuth were monitored for 2 and 24 h, respectively. After stopping therapy plasma and urine concentrations of bismuth were followed for 4 and 6 weeks, respectively. In all three groups of patients small amounts of bismuth (mean values 0.26 to 0.28% of dose) were rapidly (transient mean peak concentrations between 40 and 134 μg/L) reached within about 30 to 40 min, absorbed and alasma levels demonstrated a wide intra- and inter-individual variability. Absorption profiles were not altered during the treatment course; however, the trough plasma concentration of bismuth demonstrated an about 3- to 5-fold accumulation (correlated to creatinine clearance) from about 5 μg/L to 15 μ/L (normal renal function) or to 20–25 μ/L (impaired renal function). Pre-study bismuth levels could be detected within 2 to 4 weeks after stopping therapy in all subjects whereas urinary concentrations were still elevated 6 weeks after the course of treatment.Our results indicate that tripotassium dicitrato bismuthate is absorbed in very low amounts during standard therapy. However, dependent on renal function, accumulation to non-toxic levels does occur during a course of treatment. It appears prudent to halve tripotassium dicitrato bismuthate dosage in patients with severe renal insufficiency (creatinine clearance ± 20 ml/min) to avoid any possible toxic risks. In such patients monitoring of the plasma bismuth concentration might be helpful, especially if longer or repeated treatment is anticipated.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2036.1991.tb00518.x
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  • 3
    Electronic Resource
    Electronic Resource
    Calcium carbonate as a phosphate binder in dialysis patients: Evaluation of an enteric-coated preparation and effect of additional aluminium hydroxide on hyperaluminaemia (1991)
    Springer
    Journal of molecular medicine 69 (1991), S. 59-67 
    Details
    ISSN: 1432-1440
    Keywords: Calcium carbonate ; Phosphate ; Chronic renal failure ; Aluminium ; Hyperparathyroidism
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Calcium carbonate has been successfully used as a phosphate binder in patients with chronic renal failure; however, a high frequency of hypercalcaemia has been reported. To study the effects of calcium carbonate preparations with different dissolution characteristics on the incidence of this side effect, we conducted a double-blind, crossover trial in 21 patients undergoing chronic haemodialysis. Aluminium hydroxide therapy was replaced with calcium carbonate. The subjects then randomly received either an enteric-coated or a gastric-coated preparation. Calcium carbonate (3.1–3.6 g/d) controlled serum phosphate concentrations as effectively as aluminium hydroxide (2.9 g/d). Concurrently, there was a significant rise in mean serum calcium and a fall in serum concentrations of both parathyroid hormone and osteocalcin, the latter suggesting a decrease in bone turnover. Overall, hypercalcaemic episodes developed in 9 patients (43%) and occurred at a considerable frequency (33 episodes per 100 patient-months) during treatment with the gastric-coated formulation. Following conversion to enteric-coated calcium carbonate (3.6 g/d) patients had fewer occurrences of hypercalcaemia (12 episodes per 100 patient-months,P〈0.05) and, as compared to the gastric-coated preparation, increases in serum calcium 〉3.00 mmol/l were not observed at all. Hyperaluminaemia was regressive during therapy with calcium carbonate, but addition of small doses of aluminium hydroxide caused a large rise in serum aluminium concentrations after infusion of desferrioxamine, indicating an enhanced rate of absorption or aberrant compartmentalization of aluminium. We conclude that calcium carbonate can control hyperphosphataemia in dialysis patients. However, undesirable hypercalcaemic episodes may occur, the frequency and severity of which can be lowered by the use of an enteric-coated preparation. Concomitant use of aluminium hydroxide and calcium carbonate should be restricted to patients in whom the degree of aluminium accumulation is monitored by serial desferrioxamine tests.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01666818
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  • 4
    Electronic Resource
    Electronic Resource
    Contrast-enhanced computed tomography for demonstration of bilateral renal cortical necrosis (1994)
    Springer
    Journal of molecular medicine 72 (1994), S. 499-501 
    Details
    ISSN: 1432-1440
    Keywords: Acute renal failure ; Renal cortex necrosis ; Computed tomography ; Contrast medium
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Bilateral renal cortical necrosis as a rare form of acute renal failure was encountered in two patients with sepsis and acute renal failure. In both cases contrast-enhanced computed tomography showed characteristic findings: absent spacification of the renal cortex and enhancement of subcapsular and juxtamedullary areas and of the medulla without excretion of contrast medium. Establishing an early diagnosis and visualizing the extent of renal cortical necrosis by means of contrast-enhanced computed tomography allow a prognostic evaluation of renal function and further planning of therapy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00207477
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  • 5
    Electronic Resource
    Electronic Resource
    Intensive chemotherapy with idarubicin, ara-C, etoposide, and m-AMSA followed by immunotherapy with interleukin-2 for myelodysplastic syndromes and high-risk Acute Myeloid Leukemia (AML) (2000)
    Springer
    Annals of hematology 79 (2000), S. 30-35 
    Details
    ISSN: 1432-0584
    Keywords: Key words Acute myeloid leukemia ; Myelodysplastic syndrome ; Secondary leukemia ; Interleukin-2 ; G-CSF
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Intensive chemotherapy followed by treatment with interleukin-2 (IL-2) was evaluated in a prospective, randomized, multicenter trial including 18 patients with refractory anemia with excess of blasts in transformation (RAEB-T), 86 patients with acute myeloid leukemia (AML) evolving from myelodysplastic syndromes, and six patients with secondary AML after previous chemotherapy. Median age was 58 years (range: 18–76 years). Forty-nine patients (45%) achieved a complete remission (CR) after two induction cycles with idarubicin, ara-C, and etoposide, 52% of them aged ≤60 years and 35% aged 〉60 years (p=0.06). After two consolidation courses, patients were randomized to four cycles of either high- or low-dose IL-2. Patients aged up to 55 years with an HLA-identical sibling donor were eligible for allogeneic bone marrow transplantation. The median relapse-free survival was 12.5 months, with a probability of ongoing CR at 6.5 years of 19%. Overall survival of all patients was 8 months, and 21 months for the CR patients. Median survival was significantly longer among patients aged ≤60 years than among the older patients (16 vs 6 months, p〈0.001). Median duration of survival and relapse-free survival were not statistically different in the two IL-2 treatment arms.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002770050005
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  • 6
    Electronic Resource
    Electronic Resource
    Osteocalcin in patients with rheumatoid arthritis — effect of anatomical stages, inflammatory activity and therapy (1992)
    Springer
    Rheumatology international 12 (1992), S. 207-211 
    Details
    ISSN: 1437-160X
    Keywords: Osteocalcin ; Rheumatoid arthritis ; Anatomic stage ; Inflammatory activity ; Bone turnover
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The aim of this study was to investigate whether the degree of inflammatory activity, the anatomical stage and various treatments have an influence on bone turnover in patients with rheumatoid arthritis (RA). Osteocalcin (OC) and other parameters of bone turnover were measured in 131 patients with RA. The mean values of alkaline phosphatase (AP), but not of OC were significantly (P〈0.01) higher in our patients compared to controls. In contrast to AP, OC values increased and correlated significantly (r=+0.33, P〈0.01) with ascending anatomical stage in women not on glucocorticoid treatment. As regards therapy, we found significantly lower OC levels in women receiving steroids compared to controls (P〈0.03) and those being treated with nonsteroidal anti-inflammatory drugs (NSAIDs) (P〈0.03), methotrexate (MTX) (P〈0.05), or gold (P〈0.01). Females treated with gold had higher OC levels than patients receiving no antirheumatic drugs (P〈0.03). Furthermore, there was a significantly negative correlation between OC and inflammatory activity [C-reactive protein (CRP)] (r=-0.25, P〈0.003). In conclusion, OC levels were significantly higher (P〈0.032) in patients with advanced (anatomical) stages of RA. In contrast to AP, changes in bone turnover, such as suppression of bone formation by steroids and high inflammatory activity in patients with RA, were easily detected.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00302154
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