Ambrisentan use in a HIV-1 infected patient with end-stage renal disease and pulmonary hypertension : minimal removal by hemodialysis - a case report

Autor: Santos, José Ramón, Merino Ribas, Ana, Haefeli, Walter E., Miranda, Cristina, Prats, Marisol, Bancu, Ioana, Bailón, Lucía, Moltó, José, Universitat Autònoma de Barcelona
Rok vydání: 2020
Předmět:
Zdroj: Dipòsit Digital de Documents de la UAB
Universitat Autònoma de Barcelona
BMC Nephrology
Recercat: Dipósit de la Recerca de Catalunya
Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
BMC Nephrology, Vol 21, Iss 1, Pp 1-4 (2020)
r-IGTP. Repositorio Institucional de Producción Científica del Instituto de Investigación Germans Trias i Pujol
instname
Recercat. Dipósit de la Recerca de Catalunya
ISSN: 1471-2369
Popis: Background Ambrisentan is a selective endothelin receptor antagonist used for the treatment of pulmonary arterial hypertension (PAH). Little is known about ambrisentan removal by hemodialysis in patients with end-stage renal disease (ESRD). Case presentation A 53-year-old woman with HIV/hepatitis C virus (HCV) co-infection, PAH and ESRD on regular hemodialyis was admitted in our hospital due to refractory heart failure while on treatment with bosentan (125 mg twice daily) and tadalafil (20 mg once daily) for PAH and antiretroviral treatment (cART) including darunavir/cobicistat (800/150 mg once daily). Excessive exposure to bosentan due to drug interactions between bosentan and darunavir/cobicistat was suspected. Bosentan was replaced by ambrisentan, with progressive improvement in her clinical condition. Pre- and postdialyzer cocentrations of ambrisentan in plasma were determined and hemodialysis extraction ratio for ambrisentan was 2%. Conclusions Our results suggest that hemodialysis results in minimal ambrisentan removal, and therefore no specific ambrisentan dosage adjustment seems to be required in ESRD patients undergoing hemodialysis.
Databáze: OpenAIRE