Influence of continuous ambulatory peritoneal dialysis on serumα 1-acid glycoprotein concentration and drug binding

Abstract

The influence of continuous ambulatory peritoneal dialysis (CAPD) on the concentrations of alpha 1-acid glycoprotein in serum and dialysate and on the serum binding of oxprenolol, propranolol and phenytoin has been studied. Before starting CAPD treatment, the serum binding of oxprenolol and propranolol was higher and that of phenytoin lower than in healthy volunteers, and the serum alpha 1-AGP concentration was higher. During the first days to weeks after starting CAPD, the serum alpha 1-AGP concentration rose with a concomitant increase in the binding of oxprenolol and propranolol. Subsequently, the alpha 1-AGP level and the binding of oxprenolol and propranolol decreased to the values found before starting CAPD. The binding of phenytoin showed little change. The concentration of alpha 1-AGP in dialysate was 2 to 5% of that in serum.

Effect of baseline renal and hepatic function on the incidence of adverse drug events: the Japan Adverse Drug Events study

“…The relationship between the number of medications and occurrence of ADEs was not observed in patients with renal or hepatic dysfunction because of the decreased metabolism and excretion function. Even with only a few drugs administered, the blood concentration of these drugs or their metabolites increases causing enhanced drug sensitivity in patients with renal or hepatic dysfunction [16][17][18][19][20][21][22]. We suggested that the risk of ADEs depends on the number of medications in patients with normal metabolism, whereas the risk of ADEs was high even with a small number of medications in patients with decreased metabolism.…”