Abstract
Hemodialysis is a method that used to achieve the extracorporeal removal of waste products such as creatinine and urea and free water from the blood when the kidneys are in a state of renal failure. However, this treatment may reduce the effectiveness of certain drugs. It is necessary to study the dialysance of quinine, a drug used in first intention for the treatment of severe malaria due to the fragility of uremic patients and the presence of malaria in endemic areas. This study has been conducted at the hemodialysis center of SAMU (Service d’Aide Medicale d’Urgence) in Abidjan Cocody. Twenty one (21) subjects with chronic renal failure aged of 24 to 50 years were enrolled. Two groups of subjects were formed. Each patient of the first group (9 subjects) received per person one tablet of 500 mg of quinine base (single dose) before the hemodialysis started. The second group (12 subjects) received in perfusion 5% glucose solution (250 mL) containing 10 mg.kg-1 of quinine base during 4 hours. The perfusion system and the hemodialysis system were conducted simultaneously. The concentrations of quinine in the tablet, the perfusion solution and the human blood were determined by a validated high performance liquid chromatography method. Quinine content in tablet and perfusion solution was in agreement with the manufacturer's specifications. The clearance of quinine was 23.67 mL.min-1. It appeared of this study that quinine fraction extracted did not require dose adjustment.
Highlights
Chronic renal failure is a fairly common cause of hospitalization in internal medicine where his prognosis is terrible [1]
This treatment may reduce the effectiveness of certain drugs used to treat other illness as malaria in patients with chronic renal failure
The strategy adopted by the Ivorian national program against malaria to reduce morbidity and mortality due to severe falciparum malaria is based on quinine treatment at 25 mg/kg/24h at three times the first day and twice-daily the other days (2-5 days) [3, 4]
Summary
Chronic renal failure is a fairly common cause of hospitalization in internal medicine where his prognosis is terrible [1]. Hemodialysis is a method that used to achieve the extracorporeal removal of waste products such as creatinine, urea and free water from the blood when the kidneys are in a state of renal failure [2]. This treatment may reduce the effectiveness of certain drugs used to treat other illness as malaria in patients with chronic renal failure. Due to the fragility of uremic patients and the presence of malaria in endemic areas such as Côte d’Ivoire, it is necessary to study the dialysance of quinine, a drug used in first intention for the treatment of severe malaria. Quinine concentration determined by HPLC method [5, 6, 7] has been
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