Korean J Nephrol.
2002 Jan;21(1):67-73.
Pharmacokinetics of Antimycobacterial Drugs in Peritoneal Dialysis
- Affiliations
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- 1Division of Nephrology, College of Medicine, Seoul National University, Korea. curie@plaza.snu.ac.kr
- 2Division of Clinical Pharmacology, College of Medicine, Seoul National University, Korea.
- 3Division of Nephrology, College of Medicine, Hallym University, Korea.
- 4Division of Nephrology, Eulji University, School of Medicine, Korea.
Abstract
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BACKGROUND: Tuberculosis is more prevalent in dialysis patients than in the general population, and more difficult to make a diagnosis, and often leads to death, Moreover, extra-caution is needed in prescribing anti-tuberculosis medications as dose modification is frequently needed in patients with renal insufficiency. Several pharmacokinetic studies have been performed for antimycobacterial regimens in patients with renal insufficiency, including under hemodialysis. However, the anti-mycobacterial regimens of patients on peritoneal dialysis have been made based on empirical methods because of few pharmacokinetic studies.
METHODS
To elucidate the pharmacokinetic profiles of anti-mycobacterial regimens for peritoneal dialysis, we measured both plasma and peritosol concentrations of anti- tuberculous drugs including isoniazide, rifampin and pyrazinamide in 9 patients maintained on chronic ambulatory peritoneal dialysis(CAPD).
RESULTS
After a conventional oral dose of anti-tuberculosis medication, their plasma concentrations were in the therapeutic range, but the peritosol concentration of rifampin was below the therapeutic range.
CONCLUSION
No dose adjustments are required for isoniazid, rifampin and pyrazinamide for the treatment of systemic or peritoneal tuberculosis in CAPD patients. On the contrary, oral rifampin is not expected to be effective in the treatment of tuberculous peritonitis, because of its low peritosol concentration.
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