title: Dialysate concentration and pharmacokinetics of 2F-Ara-A in a patient with acute renal failure.
abstract: Fludarabine is frequently used for treatment of B-cell chronic lymphocytic leukemia and in conditioning regimes for hematopoietic cell transplantations. The total body clearance of the principal metabolite 2-fluoro-ara-A (2F-Ara-A) correlates with the creatinine clearance. We report data on total dialysate concentration as well as pharmacokinetics of 2F-Ara-A in a patient with anuric acute renal failure. On three consecutive days the patient received a daily dose of 80 mg (40 mg/m(2)) fludarabine and underwent three consecutive extended (daily) dialysis (ED) sessions. ED removed a considerable amount of the drug. The average dialysis clearance was 33.85 ml/min which is about 25% of the clearance in patients without renal failure. No toxic side effects of the treatment were observed. This case suggests that fludarabine treatment can be considered in patients requiring dialysis if dose reduction and adequate removal of the drug by hemodialysis is provided.
authors.affiliation: Department of Nephrology, Hannover Medical School, Hannover, Germany. Kielstein@yahoo.com
authors.forename: Jan T
authors.initials: JT
authors.lastname: Kielstein
authors.forename: Michael
authors.initials: M
authors.lastname: Stadler
authors.forename: David
authors.initials: D
authors.lastname: Czock
authors.forename: Frieder
authors.initials: F
authors.lastname: Keller
authors.forename: Bernd
authors.initials: B
authors.lastname: Hertenstein
authors.forename: Jörg
authors.initials: J
authors.lastname: Radermacher
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology / Q000628:therapy*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000493:pharmacokinetics*; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000150:complications / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D014740:Vidarabine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000493:pharmacokinetics*
chemical_list: D007166:Immunosuppressive Agents; D014740:Vidarabine; C024352:fludarabine