Elimination of iomeprol in patients undergoing continuous ambulatory peritoneal dialysis.
OBJECTIVE
To examine the elimination of iomeprol, its safety in clinical use, and its peritoneal permeability in continuous ambulatory peritoneal dialysis (CAPD) patients with variable degrees of residual renal function (RRF).


METHODS
A nonrandomized comparison study.


METHODS
Hospitalized patients in CAPD unit of Chikuho and University Hospitals.


METHODS
Fourteen patients treated by CAPD and 6 by hemodialysis (HD).


METHODS
Total dialysate, blood, and 24-hour urine collections were obtained for 4 consecutive days after the administration of iomeprol. A peritoneal equilibration test was performed just before and after the administration of iomeprol.


METHODS
Iomeprol (iodine) concentration was measured. Residual renal function was estimated as the mean of renal creatinine and urea clearances. Dialysate-to-plasma ratios (D/P) of creatinine and iomeprol were also determined.


RESULTS
In all CAPD patients, plasma iomeprol clearance was markedly slow, with a biological half-life (T1/2) of over 32 hours. However, no patients suffered from any adverse effects, and over 80% of plasma iomeprol was eliminated during the 4-hour HD. The plasma iomeprol elimination rate was significantly higher from 4 hours after the iomeprol administration in CAPD patients with RRF [mean estimated creatinine clearance (CCr) 3.8 mL/min, n = 7] compared to the remaining patients (mean estimated CCr 0.6 mL/min, n = 7); however, T1/2 in patients with RRF was over 24 hours. D/P creatinine was significantly correlated with D/P iomeprol, and peritoneal iomeprol permeability may depend on an individual's peritoneal solute transport properties.


CONCLUSIONS
A prolonged elimination rate of iomeprol was documented in our CAPD patients both with and without RRF. A HD procedure or intensive peritoneal dialysis just after the use of iomeprol may be advisable to promptly remove circulating iomeprol.
Iwamoto
M
M
Second Department of Internal Medicine, School of Medicine, University of Environmental and Occupational Health, Kitakyushu City, Japan.
Hiroshige
K
K
Suda
T
T
Ohta
T
T
Ohtani
A
A
Nakashima
Y
Y
D003287:Contrast Media / Q000032:analysis / Q000493:pharmacokinetics*; D015314:Dialysis Solutions / Q000737:chemistry; D005260:Female; D006801:Humans; D007479:Iopamidol / Q000031:analogs & derivatives* / Q000032:analysis / Q000493:pharmacokinetics; D007668:Kidney / Q000503:physiopathology; D007676:Kidney Failure, Chronic / Q000503:physiopathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory; D006435:Renal Dialysis
D003287:Contrast Media; D015314:Dialysis Solutions; C057937:iomeprol; D007479:Iopamidol