Single-Dose Pharmacokinetics and Total Removal of Cyclophosphamide in a Patient with Acute Kidney Injury Undergoing Intermittent Haemodialysis and Prolonged Intermittent Kidney Replacement Therapy: A Case Report

The largest study on cyclophosphamide pharmacokinetics in dialysis patients comprises of 6 subjects. In the 2 decades since these data were obtained, dialyser membranes, treatment intensities, and treatment duration have changed considerably making new pharmacokinetic studies desirable. We aimed to...

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Bibliographic Details
Published in:Case reports in nephrology and dialysis 2023-01, Vol.13 (1), p.70-74
Main Authors: Lück, Catherina, Beutel, Gernot, Kühn-Velten, W. Nikolaus, Kielstein, Jan T.
Format: Article
Language:English
Subjects:
Bone marrow
cancer
Case reports
Conflicts of interest
Creatinine
cyclophosphamide
Dialysate
Drug dosages
drug dosing
Hemodialysis
Kidney diseases
Metabolites
Patients
Pharmacokinetics
Pneumonia
Renal replacement therapy
Single Case
Citations: Items that this one cites
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Summary:The largest study on cyclophosphamide pharmacokinetics in dialysis patients comprises of 6 subjects. In the 2 decades since these data were obtained, dialyser membranes, treatment intensities, and treatment duration have changed considerably making new pharmacokinetic studies desirable. We aimed to readdress the pharmacokinetics of cyclophosphamide in a 74-year-old critically ill male suffering from ANCA-associated vasculitis. Due to an acute-on-chronic kidney injury, he underwent intermittent (IHD) and prolonged intermittent kidney replacement therapy (PIKRT). IHD was started 7 h after end of a cyclophosphamide infusion with a blood/dialysate flow of 300 mL/min for 255 min, followed by PIKRT with a blood/dialysate flow of 140 mL/min for 540 min, both using a 1.3 m 2 polysulphone high-flux dialyser (F60S, Fresenius Medical Care). Peak concentration of cyclophosphamide was 20.2 mg/L. Using IHD and PIKRT serum concentration of cyclophosphamide decreased to 1.2 mg/L after IHD and to 50% of the recommended for patient with normal renal function may be applied, as complete elimination of the parent drug by modern dialysis is feasible.
ISSN:2296-9705
2296-9705
DOI:10.1159/000531129