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Nephrol Dial Transplant (1995) 10: 2266-2268
© 1995 European Renal Association-European Dialysis and Transplant Association

research-article

Removal of clodronate by haemodialysis in end-stage renal disease patients

A. E. Beigel1,, E. Rienhoff2 and C. J. Olbricht1

1Division of Nephrology, Medical School Hannover Hannover 2Boehringer Mannheim GmbH Germany

Correspondence and offprint requests to: Correspondence and offprint requests to: Dr Andrea E. Beigel, Abteilung Nephrologie, Medizinische Hochschule Hannover, D-30625 Hannover, Germany

BACKGROUND: Clodronate is a potent calcium-lowering drug. The effect of haemodialysis on clodronate pharm-acokinetics is unknown.

METHODS: The removal of clodronate by haemodialysis was determined in 10 end-stage renal disease patients (ESRD). A 2-h infusion of 300 mg of clodronate was followed immediately by a 4-h haemodialysis. Vascular access was by AV fistula. A 1.5-m2 cuprophane hollow-fibre dialyser was applied. Blood flow was 205±15ml/min, dialysate flow 523±29 ml/min. Clodronate was determined by high-performance liquid chromatography in total collected dialysate, and in blood before and after the dialyser at initiation, 2 h, and 4 h of HD.

RESULTS: The initial predialyser serum concentration of clodronate was 13.6 ± 4 ug/ml. It decreased to 4.9 ± 0.5 ug/ml and 2.6 ± 0.5 ug/ml at 2h and 4h respectively. The clearance of clodronate (86 ± 10 ml/min) remained unchanged during HD. Clodronate in total collected dialysate per single 4-h HD was 105 ± 16 mg (35% of injected dose).

CONCLUSIONS: We conclude that clodronate is effectively removed from plasma by HD. The present data together with information provided by previous studies suggest that 300 mg of clodronate given as an 2-h infusion immediately prior to haemodialysis is an adequate dosage for ESRD patients.

Keywords: clodronate; haemodialysis; end-stage renal disease


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