Pharmacokinetics of zidovudine in end-stage renal disease: influence of haemodialysis.
OBJECTIVE
To study the pharmacokinetics of zidovudine (ZDV) and its glucoronide metabolite (G-ZDV) in a patient with end-stage renal disease in haemodialysis.


METHODS
Pharmacokinetics study performed during and between haemodialysis sessions.


METHODS
The patient was treated with oral ZDV (100 mg every 8 h). Concentrations of ZDV and G-ZDV were measured by radioimmunoassay. A monocompartmental model was used to calculate pharmacokinetic parameters.


RESULTS
The peak plasma concentrations of ZDV and G-ZDV after drug administration between haemodialysis sessions were 0.57 and 10.01 micrograms/ml, respectively. The half-lives of ZDV and G-ZDV rose to 3.2 and 14.2 h, respectively. The total body clearance for ZDV in the period between haemodialysis sessions (0.44 l/kg/h) was 66% lower than normal values. The ZDV half-life was normalized by haemodialysis, the total body clearance of ZDV increased (1.12 l/kg/h) and the G-ZDV half-life shortened (5.9-7.9 h). Neither G-ZDV accumulation nor derived ZDV toxicity occurred.


CONCLUSIONS
Our data suggest that ZDV is safe and an efficient drug when administered at a dosage of 100 mg three times daily in patients with end-stage renal disease in haemodialysis sessions, and that ZDV and G-ZDV are cleared by haemodialysis.
Pachon
J
J
Infectious Diseases Unit, Hospital Universitario Virgen del Rocio, Sevilla, Spain.
Cisneros
J M
JM
Castillo
J R
JR
Garcia-Pesquera
F
F
Cañas
E
E
Viciana
P
P
D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D015215:Zidovudine / Q000493:pharmacokinetics* / Q000627:therapeutic use
D015215:Zidovudine