title: Effect of peritoneal dialysis on plasma and peritoneal fluid concentrations of isoniazid, pyrazinamide, and rifampin.
abstract: OBJECTIVE
  This study was performed to elucidate the pharmacokinetic profiles of antimycobacterial regimens for peritoneal dialysis patients.
  
  
  METHODS
  Nine patients on maintenance continuous ambulatory peritoneal dialysis (CAPD) were included in this study.
  
  
  METHODS
  After administering a conventional oral dose of antituberculosis medications, we measured plasma and peritoneal fluid concentrations of isoniazid by fluorometry, and rifampin and pyrazinamide by high performance liquid chromatography. The assay data were subjected to pharmacokinetic analysis.
  
  
  RESULTS
  Average peak plasma concentrations of isoniazid, rifampin, and pyrazinamide were 3.3 mg/L, 6.5 mg/L, and 30.9 mg/L, respectively, all of which much exceed the minimum inhibitory concentration (MIC) for Mycobacterium tuberculosis. Peritoneal fluid concentrations of isoniazid and pyrazinamide were maintained well above the MICs for M. tuberculosis; however, peritoneal fluid concentration of rifampin was below the therapeutic range most of the time.
  
  
  CONCLUSIONS
  For the treatment of systemic or pulmonary tuberculosis in CAPD patients, no dose adjustments are required for isoniazid, rifampin, or pyrazinamide. On the contrary, for the treatment of tuberculous peritonitis, oral rifampin therapy is not expected to be effective because of its low peritoneal fluid concentration.
authors.affiliation: Department of Nephrology, College of Medicine, Seoul National University, Seoul, Korea.
authors.forename: Curie
authors.initials: C
authors.lastname: Ahn
authors.forename: Kook-Hwan
authors.initials: KH
authors.lastname: Oh
authors.forename: Kiwon
authors.initials: K
authors.lastname: Kim
authors.forename: Kyung Yi
authors.initials: KY
authors.lastname: Lee
authors.forename: Jung Geon
authors.initials: JG
authors.lastname: Lee
authors.forename: Myung Don
authors.initials: MD
authors.lastname: Oh
authors.forename: Yonsu
authors.initials: Y
authors.lastname: Kim
authors.forename: Jin Suk
authors.initials: JS
authors.lastname: Han
authors.forename: Suhnggwon
authors.initials: S
authors.lastname: Kim
authors.forename: Jung Sang
authors.initials: JS
authors.lastname: Lee
authors.forename: In-Jin
authors.initials: IJ
authors.lastname: Jang
authors.forename: Sang-Goo
authors.initials: SG
authors.lastname: Shin
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000032:analysis / Q000097:blood / Q000493:pharmacokinetics*; D001202:Ascitic Fluid / Q000737:chemistry*; D005260:Female; D006801:Humans; D007538:Isoniazid / Q000032:analysis / Q000097:blood / Q000493:pharmacokinetics*; D008297:Male; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000379:methods*; D011718:Pyrazinamide / Q000032:analysis / Q000097:blood / Q000493:pharmacokinetics*; D012293:Rifampin / Q000032:analysis / Q000097:blood / Q000493:pharmacokinetics*
chemical_list: D000995:Antitubercular Agents; D011718:Pyrazinamide; D007538:Isoniazid; D012293:Rifampin