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NDT Advance Access published online on February 1, 2005
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfh676
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Nephrol Dial Transplant © ERA-EDTA 2005; all rights reserved
Received September 6, 2004
Accepted November 19, 2004

Original Articles

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

Tomohisa Teraoka 1*, Takao Sugai 2, Sunao Nakamura 2, Hiroyuki Hirasawa 3, Shigeto Oda 3, Hidetoshi Shiga 3, Mio Suga 1, Shinji Yamane 4, Hiroyuki Ishii 4, Shin-ichi Yamagata 1, Nobunori Satoh 1, and Shiro Ueda 1

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

* To whom correspondence should be addressed.
Tomohisa Teraoka, E-mail: tera{at}p.chiba-u.ac.jp



  Abstract

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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