Pharmacokinetics of Carboplatin in a Patient with Cervical Cancer with Ureteric Obstruction Before, During, and After Hemodialysis

Abstract

The pharmacokinetics of total and free (ultrafilterable) platinum were investigated in a patient with cervical cancer with ureteric obstruction who, at the time of carboplatin administration, appeared to have a mild renal impairment (i.e., creatinine clearance 1 mL/s), but developed an acute renal failure shortly thereafter, which required hemodialysis. The decline in the concentration of total or free Pt in plasma as function of time correlated well (P < 0.0098) with that of serum creatinine concentration. The elimination half-lives (t1/2) of total and free Pt in this patient were eight- and nine-fold longer than those observed earlier for patients with normal renal function, and the total body clearance was 12.4% and 18.4%, respectively. Although t1/2 of Pt during dialysis was two to three times (total Pt) and eight times (free Pt) shorter than those observed before and after dialysis, three sessions of hemodialysis removed only 5.6% of total Pt and 9.3% of free Pt. Because the pre- and post-dialysis t1/2 values were similar, hemodialysis apparently had no impact on the intrinsic elimination of Pt in this patient.