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NDT Advance Access originally published online on February 1, 2005
Nephrology Dialysis Transplantation 2005 20(4):754-759; doi:10.1093/ndt/gfh676
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© The Author [2005]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oupjournals.org

Original Article

Prediction of iopromide reduction rates during haemodialysis using an in vitro dialysis system

Tomohisa Teraoka1, Takao Sugai2, Sunao Nakamura2, Hiroyuki Hirasawa3, Shigeto Oda3, Hidetoshi Shiga3, Mio Suga1, Shinji Yamane4, Hiroyuki Ishii4, Shin-ichi Yamagata1, Nobunori Satoh1 and Shiro Ueda1

1 Department of Drug Information and Communication, Graduate School of Pharmaceutical Sciences, Chiba University, 2 Shin-Tokyo Hospital, 3 Department of Emergency and Critical Care Medicine, Chiba University School of Medicine and 4 Division of Blood Purification, Chiba University Hospital, Chiba, Japan

Correspondence and offprint requests to: Tomohisa Teraoka, Department of Drug Information and Communication, Graduate School of Pharmaceutical Sciences, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 260-8675, Japan. Email: tera{at}p.chiba-u.ac.jp

Background. In clinical studies, it has been difficult to evaluate the influence of haemodialysis (HD) parameters on HD clearance (CLHD) and reduction rate (RR) of non-ionic contrast medium during HD sessions. We therefore predicted clinical values of CLHD and RR of iopromide, a non-ionic contrast medium, from findings obtained from in vitro experiments, and confirmed that these predictive values were comparable with the actual values in clinical cases.

Methods. We developed a correlation equation for predicting CLHD on the basis of in vitro HD experiments by varying blood flow rates between 100 and 200 ml/min with a cuprammonium rayon dialyser (AM-SD-10H). Total body clearance of iopromide (CLPT) was estimated by the Cockroft–Gault equation. The volume of distribution (Vd) was obtained from the reported value. By using the HD and three pharmacokinetic parameters (CLHD, CLPT and Vd), we predicted CLHD and RR for seven patients undergoing HD after the administration of iopromide.

Results. In the in vitro study, the mean values (±SD) of iopromide clearance at blood flow rates of 100, 150 and 200 ml/min were 45.35 (2.54), 53.88 (6.46) and 57.61 (4.72) ml/min, respectively. There were highly significant correlations between clearance and blood flow rate (r = 0.975). Although the predicted CLHD showed a tendency towards underestimation, a good correlation was found. Predicted RR values were similar to observed values except for one case.

Conclusion. The in vitro model used in the present study provides pertinent information about CLHD and is helpful for predicting RR during HD in individual patients undergoing HD.

Keywords: drug removal; haemodialysis; iopromide; pharmacokinetics; radiocontrast media


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