Estimation of statistical moments for desferrioxamine and its iron and aluminum chelates: contribution to optimisation of therapy in uremic patients.
We investigated the best time of administration of desferrioxamine (DFO) with respect to the dialysis session, using the approach of the stochastic dynamic system, integrated with the classical pharmacokinetic models. In the 6 patients studied, the mean arrival times of DFO, aluminoxamine (AlO) and ferrioxamine (FO) were, respectively, 193, 1,350 and 126 min, the mean residence times were 1,048, infinite, 1,190 min, respectively. AlO serum levels reach steady state in a mean time of 7 h and 22 min and remain stable in the interdialytic period. FO achieves a peak at the end of DFO infusion and declines during the interdialytic period. DFO, AlO and FO persist a very long time in the body of the uremic patient, thus the dialysis session should be administered when AlO and FO reach steady state. With a dose of 5-10 mg/kg b.w. of DFO, we propose to start the dialysis 8-12 h after the infusion if the main purpose is to treat Al overload or 2-3 h after the infusion if the main purpose is the treatment of hemosiderosis.
Andriani
M
M
Nephrology and Dialysis Unit, Ospedale Civile, Dolo, Venice, Italy.
Nordio
M
M
Saporiti
E
E
D000535:Aluminum / Q000097:blood; D000931:Antidotes / Q000008:administration & dosage / Q000493:pharmacokinetics*; D002614:Chelating Agents / Q000008:administration & dosage / Q000493:pharmacokinetics; D003627:Data Interpretation, Statistical; D003676:Deferoxamine / Q000008:administration & dosage / Q000493:pharmacokinetics*; D004334:Drug Administration Schedule; D005290:Ferric Compounds / Q000008:administration & dosage / Q000493:pharmacokinetics*; D006486:Hemosiderosis / Q000188:drug therapy; D006801:Humans; D007262:Infusions, Intravenous; D007501:Iron / Q000097:blood; D007676:Kidney Failure, Chronic / Q000097:blood / Q000378:metabolism / Q000628:therapy; D008875:Middle Aged; D009942:Organometallic Compounds / Q000008:administration & dosage / Q000493:pharmacokinetics*; D006435:Renal Dialysis; D014511:Uremia / Q000378:metabolism / Q000628:therapy*
D000931:Antidotes; D002614:Chelating Agents; D005290:Ferric Compounds; D009942:Organometallic Compounds; C002577:ferrioxamine B; C049544:aluminoxamine; D000535:Aluminum; D007501:Iron; D003676:Deferoxamine