Single‐Dose Pharmacokinetics and Safety of Solriamfetol in Participants With Normal or Impaired Renal Function and With End‐Stage Renal Disease Requiring Hemodialysis

We investigated the pharmacokinetics of non-metabolized cefotaxime in 10 patients undergoing CAPD. The elimination half-life after IV administration of I g cefotaxime was 3.1 ± 1.3 hr, i.e. two to three times longer than in individuals with normal renal function but similar to patients with severe renal insufficiency. An average of 2.18% of the dose was recovered in the effluent. The halflife of I g cefotaxime administered in the dialysis solutions was 1.4 ± 0.8 hr. This difference between the half-lives after intraperitoneal and intravenous administration indicates a faster transport through the peritoneal membrane. Intraperitoneally administered cefotaxime -250 mg four times daily, was effective in the treatment of peritonitis in three CAPD patients. Since its introduction in 1976, CAPD has become an effective therapy for end-stage renal disease. The most serious complication is peritonitis and effective treatment is essential. Cefotaxime, a new broad-spectrurn cephalosporin, is active against most gramnegative and gram-positive organisms. It possesses no nephrotoxicity and may be useful in the treatment of peritonitis and other infections in patients on CAPD. This study was done to evaluate the pharmacokinetics of cefotaxime administered intravenously and intraperitoneally during CAPD.

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Elective Surgery in Patients with End Stage Renal Disease: What's the Risk?

The American Surgeon ◽

10.1177/000313480907500909 ◽

2009 ◽

Vol 75 (9) ◽

pp. 790-793 ◽

Cited By ~ 22

Author(s):

Christopher R. Schneider ◽

William Cobb ◽

Shivani Patel ◽

David Cull ◽

Cass Anna ◽

...

Keyword(s):

Renal Function ◽

Renal Disease ◽

Surgical Procedures ◽

General Surgery ◽

Normal Renal Function ◽

End Stage Renal Disease ◽

Elective Surgical Procedures ◽

Stage Renal Disease ◽

End Stage ◽

Esrd Patients

Little research has been performed in regards to the morbidity and outcomes associated with elective general surgery performed on patients with end stage renal disease (ESRD). With minimal data about the severity of disease in these patients, we sought to quantify the differences in the ESRD patient undergoing elective surgical procedures compared with matched controls. A review of all ESRD patients undergoing elective surgical procedures at a University Medical Center between 2001 and 2005 was performed. Outcomes included length of hospital stay, 1 year morbidity, and mortality. These patients were then compared with a control group with normal renal function matched 2:1. Fifty-two consecutive ESRD patients undergoing elective general surgery procedures were compared with 104 matched controls. The ESRD group experienced more complications (25 vs 16, P = 0.05) and had a larger number of overall complications compared with the controls (33 vs 19, P < 0.05). Length of stay was significantly longer in the ESRD group as well (8 vs 2.65 days, P < 0.0001). Incidence of death (4%) in the ESRD group was increased as well. Patients with ESRD require longer hospital stays and have an increased overall incidence and frequency of complications than patients with normal renal function undergoing elective general surgery procedures. The significantly increased morbidity should be considered when evaluating expected outcomes.

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