Kinetics of elimination of thiocyanate in 7 healthy subjects and in 8 subjects with renal failure

Abstract

The concentration of thiocyanate in the serum of eight test subjects with renal failure and seven healthy control subjects was measured, as it declined with time, after oral doses of thiocyanate or i.v. injections of nitroprusside had been administered. Additional measurements were taken, on the healthy subjects only, of the concentrations of thiocyanate in the urine, and also of the influence of an increased chloride intake on the rate of elimination of thiocyanate. For the healthy subjects an elimination half-life of between one and five days (mean c. 3 days) was found. Increasing the chloride elimination rate to approximately twice normal did not significantly speed up the rate of thiocyanate elimination. The amounts of thiocyanate which had been administered as doses reappeared almost exclusively in the urine. For the subjects with renal failure, the elimination half-life had a mean value of approximately nine days. The elimination constants were found to be proportional to the creatinine-clearance rates. The ke value at a creatinine-clearance of zero ml/min was approximately 15% of the ke value at a creatinine-clearance rate of 120 ml/min. The distribution volumes for thiocyanate were greater for the patients with renal failure than for the healthy subjects. The conclusions for therapies using nitroprusside are discussed.

Toxicokinetics of cyanide in rats, pigs and goats after oral dosing with potassium cyanide

“…In healthy humans, the mean elimination half-life of thiocyanate was estimated as 2.7 days, whereas in patients with renal insufficiency it rose to 9 days (Schulz et al 1979). Thus, the efficiency of kidney excretion is a determinant factor for thiocyanate elimination, and the animal species should be a factor that affects its efficacy.…”

Biochemical verification of tobacco use and cessation

“…Its excretion rate depends on kidney function. With normal kidney function, half-lives of 3-14 days have been reported in different studies (Schulz, Bonn, & Kindler, 1979). Even non-smokers have a considerable level of SCN in the body, derived from foods.…”

Can we prevent or treat renal dysfunction in acute heart failure?

“…Actually, in patients with HF, nitrates and sodium nitroprusside do not have a direct influence on fluid overload and do not improve renal blood flow [86]. In addition, nitroprusside has long been recognized as being potentially damaging in patients with renal dysfunction, because of the accumulation of thiocyanate [87]. However, in patients with acute HF and normal to high blood pressure, compared with high doses of furosemide alone, treatment with nitrates added to low doses of furosemide has been shown to be associated with better outcomes [88].…”