Ranitidine clearance during hemodialysis with high-flux membrane: comparison of polysulfone and cellulose acetate hemodialyzers.
OBJECTIVE
To compare the effect of hemodialysis using two different types of dialyzer membranes, polysulfone (PS), a high-flux membrane, and cuprophane (CP), a conventional membrane, on blood ranitidine concentration.


BACKGROUND
Recent advances in hemodialyzer membranes have improved the removal of small and middle size uremic toxins, while little is known about the change of drug removal by new membranes.


METHODS
Eight patients with chronic renal failure who received ranitidine (150 mg/day) on a chronic basis were included. During the dialysis, blood samples were obtained from both the arterial and venous sides (before and after, respectively) of the dialyzer.


RESULTS
Serum concentration of ranitidine decreased more on PS [54 +/- 3% (+/- SEM) reduction after 3 h] than on CP (35 +/- 4%). The dialyzer clearance of ranitidine on PS membrane (67.2 +/- 4.4 ml/min/m2) was significantly higher than that on CP (43.1 +/- 3.8 ml/min/m2, P < 0.001). Elimination fraction (EF) of the drug during the dialysis with PS was also significantly higher than that with CP (72 +/- 2% versus 44 +/- 3%). Apparent half-life of ranitidine during dialysis with PS (2.9 +/- 0.4 h) was shorter than that with CP (5.1 +/- 0.7 h). However, the amount of ranitidine removed by a single dialysis with PS membrane was less than 20 mg.


CONCLUSIONS
Ranitidine clearance by hemodialysis is significantly higher with PS than with CP. Although additional dose adjustment may not be needed for ranitidine, the type of dialyzer membrane can affect drug elimination and should be taken into account for consideration of drug removal by hemodialysis.
Tsuruoka
S
S
Department of Clinical Pharmacology, Jichi Medical School, 3311-1 Yakushiji, Minamikawachi, Kawachi, Tochigi 329-0498, Japan. tsuru@jichi.ac.jp
Sugimoto
K I
KI
Hayasaka
T
T
Saito
T
T
Fujimura
A
A
D002482:Cellulose / Q000031:analogs & derivatives*; D005260:Female; D006635:Histamine H2 Antagonists / Q000097:blood / Q000493:pharmacokinetics*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood; D008297:Male; D008567:Membranes, Artificial; D008875:Middle Aged; D011108:Polymers; D011899:Ranitidine / Q000097:blood / Q000493:pharmacokinetics*; D006435:Renal Dialysis / Q000379:methods*; D013450:Sulfones
D006635:Histamine H2 Antagonists; D008567:Membranes, Artificial; D011108:Polymers; D013450:Sulfones; C017662:polysulfone P 1700; D011899:Ranitidine; D002482:Cellulose; C009865:cuprammonium cellulose