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Ahn C, Oh KH, Kim K, Lee KY, Lee JG, Oh MD, Kim Y, Han JS, Kim S, Lee JS, Jang IJ, Shin SG. Effect of Peritoneal Dialysis on Plasma and Peritoneal Fluid Concentrations of Isoniazid, Pyrazinamide, and Rifampin. ARCH ESP UROL 2003. [DOI: 10.1177/089686080302300409] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
♦ Objective This study was performed to elucidate the pharmacokinetic profiles of antimycobacterial regimens for peritoneal dialysis patients. ♦ Patients 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. ♦ Conclusion 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.
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Affiliation(s)
- Curie Ahn
- Departments of Nephrology, College of Medicine, Seoul National University
| | - Kook-Hwan Oh
- Department of Nephrology, College of Medicine, Hallym University
| | - Kiwon Kim
- Departments of Nephrology, College of Medicine, Seoul National University
| | - Kyung Yi Lee
- Departments of Nephrology, College of Medicine, Seoul National University
| | - Jung Geon Lee
- Department of Nephrology, Eulji University School of Medicine, Seoul, Korea
| | - Myung Don Oh
- Departments of Nephrology, College of Medicine, Seoul National University
| | - Yonsu Kim
- Departments of Nephrology, College of Medicine, Seoul National University
| | - Jin Suk Han
- Departments of Nephrology, College of Medicine, Seoul National University
| | - Suhnggwon Kim
- Departments of Nephrology, College of Medicine, Seoul National University
| | - Jung Sang Lee
- Departments of Nephrology, College of Medicine, Seoul National University
| | - In-jin Jang
- Clinical Pharmacology, College of Medicine, Seoul National University
| | - Sang-Goo Shin
- Clinical Pharmacology, College of Medicine, Seoul National University
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