The impact of peritoneal dialysis on oxypurinol and urate elimination in people with gout.

Autor: Wilson LC; Department of Medicine, Dunedin School of Medicine, Dunedin, New Zealand., Ward J; Department of Medicine, Dunedin School of Medicine, Dunedin, New Zealand., Wright DFB; School of Pharmacy, University of Otago, Dunedin, New Zealand.; Sydney Pharmacy School, University of Sydney, Sydney, New South Wales, Australia., Green SC; Department of Medicine, University of Otago, Christchurch, New Zealand., Stocker SL; Sydney Pharmacy School, University of Sydney, Sydney, New South Wales, Australia.; Department of Clinical Pharmacology & Toxicology, St Vincent's Hospital Sydney, Sydney, New South Wales, Australia.; Sydney Musculoskeletal Health, Univ. of Sydney, Sydney, New South Wales, Australia., Putt TL; Department of Medicine, Dunedin School of Medicine, Dunedin, New Zealand., Schollum JBW; Department of Medicine, Dunedin School of Medicine, Dunedin, New Zealand., Walker RJ; Department of Medicine, Dunedin School of Medicine, Dunedin, New Zealand.
Jazyk: angličtina
Zdroj: Nephrology (Carlton, Vic.) [Nephrology (Carlton)] 2024 Aug; Vol. 29 (8), pp. 547-550. Date of Electronic Publication: 2024 Apr 16.
DOI: 10.1111/nep.14306
Abstrakt: Gout affects 15%-30% of individuals with advanced kidney disease. Allopurinol which is rapidly and extensively metabolised to an active metabolite, oxypurinol, is the most commonly prescribed urate-lowering therapy. Oxypurinol is almost entirely eliminated by the kidneys (>95%) and has an elimination half-life of 18-30 h in those with normal kidney function. However, oxypurinol pharmacokinetics are poorly understood in individuals with kidney failure on peritoneal dialysis. This study characterised the elimination of oxypurinol and urate in people with gout receiving peritoneal dialysis. Oxypurinol steady-state oral clearance (CL/F), elimination half-life as well as kidney (CL k ) and peritoneal (CL pd ) clearances for oxypurinol and urate were calculated from the plasma, urine and dialysate concentration data for each individual. Our results demonstrate that oxypurinol and urate are removed by peritoneal dialysis, accounting for more than 50% of oxypurinol and urate clearances. An allopurinol dose about 50%-60% lower than the usual dose used for a patient with normal kidney function will provide adequate urate-lowering therapy.
(© 2024 The Authors. Nephrology published by John Wiley & Sons Australia, Ltd on behalf of Asian Pacific Society of Nephrology.)
Databáze: MEDLINE
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