Disposition of foscarnet during peritoneal dialysis.
OBJECTIVE
To report the disposition of foscarnet in a patient undergoing peritoneal dialysis.


METHODS
A 34-year-old man with AIDS received foscarnet for the treatment of esophageal cytomegalovirus. We characterized the clearance of foscarnet in this patient during continuous cyclic peritoneal dialysis (CCPD) and continuous ambulatory peritoneal dialysis (CAPD).


CONCLUSIONS
The foscarnet half-lives during CCPD and CAPD were 41.4 and 45.8 hours, respectively. These values are significantly greater than the half-life of 4.5 hours observed in patients with normal renal function and about half that reported in anuric patients undergoing hemodialysis during the interdialytic period. The CCPD and CAPD clearances of foscarnet were 5.8 and 4.5 mL/min, respectively; the CAPD clearances of creatinine and urea nitrogen were 4.1 and 6.0 mL/min, respectively. The patient's estimated total body clearance values of foscarnet during CCPD and CAPD were 9.8 and 8.8 mL/min, respectively. Thus, CCPD and CAPD augmented the patient's residual clearance of foscarnet by 145% and 105%, respectively.


CONCLUSIONS
Since incremental increases in residual clearance of 30% or more generally will result in clinically significant changes in a drug's serum concentration, foscarnet dosage needs to be individualized for patients receiving peritoneal dialysis.
School of Pharmacy, University of Pittsburgh, PA 15261, USA.
A C
AC
Alexander
A
A
Akers
G R
GR
Matzke
F T
FT
Aweeka
D S
DS
Fraley
D058186:Acute Kidney Injury / Q000628:therapy; D000328:Adult; D003586:Cytomegalovirus Infections / Q000188:drug therapy; D017245:Foscarnet / Q000009:adverse effects / Q000493:pharmacokinetics*; D006207:Half-Life; D006801:Humans; D008297:Male; D010530:Peritoneal Dialysis; D010531:Peritoneal Dialysis, Continuous Ambulatory
D017245:Foscarnet