Moderate Impairment Of Renal Function Research Articles

The disposition of cyclophosphamide in a group of myeloma patients.

The disposition of cyclophosphamide and its alkylating metabolites was investigated in a group of myeloma patients with varying degrees of renal function impairment. No correlation between renal function and clearance of cyclophosphamide or its alkylating metabolites was found. No evidence of accumulation of cyclophosphamide or alkylating activity was found in four patients receiving radiolabelled cyclophosphamide. Renal function was found to be related to the reciprocal of the area under curve of alkylating activity, indicating that this area increased as renal function decreased. In view of the large nonrenal component of alkylating activity elimination and the large inter-subject variability, it is recommended that dose of cyclophosphamide is not altered in moderate impairment of renal function.

The effect of impairment of renal function and dialysis on the serum and urine levels of clindamycin.

A single 150 mg oral dose of clindamycin was given to three healthy volunteers and 13 patients with varying degrees of renal functional impairment. The mean peak serum levels in the two groups were 2.55 +/- 0.92 mug/ml and 3.39 +/- 0.68 mug/ml respectively. In all patients the levels greatly exceeded the minimum inhibitory concentration for sensitive pathogens. The serum half-life was extremely variable in patients with renal failure and bore no relationship to the glomerular filtration rate. In the normal subjects 11.9% of the administered dose was excreted in the urine but in severe renal failure less than 1% of the bioactivity was detected in the urine in 24 hours. The drug was not removed by haemodialysis. In patients with mild to moderate impairment of renal function no dosage adjustment of clindamycin is necessary. However, in those with severe renal failure some modification to dosage would be prudent and this should be monitored by measuring serum levels of the antibiotic.

The natural history of hypertension with moderate impairment of renal function.

1. A continuing prospective study of patients with severe hypertension is now in its eighteenth year. 2. Patients with impaired renal function survive longer with present-day management if control of pressure is good and if renal structural abnormalities are not gross. 3. Since 1960 myocardial infarction, rather than cerebrovascular accident, has been the commonest cause of death.