Minimal Removal of Raltegravir by Hemodialysis in HIV-Infected Patients with End-Stage Renal Disease

ABSTRACT Little is known about raltegravir removal by hemodialysis in patients with end-stage renal disease (ESRD). We therefore measured raltegravir concentrations in plasma in pre- and postdialyzer blood samples from 2 ESRD HIV-infected patients. The hemodialysis extraction ratio and raltegravir hemodialysis clearance were 5.5% and 9.1 ml/min in patient 1 and 9.5% and 19.1 ml/min in patient 2, respectively. Our results suggest minimal raltegravir removal by hemodialysis with no specific raltegravir dosage adjustments required in HIV-infected patients undergoing hemodialysis.

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Immunodiagnosis and molecular validation of Toxoplasma gondii infection among patients with end-stage renal disease undergoing haemodialysis

Parasitology ◽

10.1017/s0031182019001033 ◽

2019 ◽

Vol 146 (13) ◽

pp. 1683-1689 ◽

Cited By ~ 1

Author(s):

Zahra Arab-Mazar ◽

Shirzad Fallahi ◽

Davood Yadegarynia ◽

Amirreza Javadi Mamaghani ◽

Seyyed Javad Seyyed Tabaei ◽

...

Keyword(s):

Toxoplasma Gondii ◽

Renal Disease ◽

End Stage Renal Disease ◽

Immunoglobulin M ◽

Enzyme Linked Immunosorbent Assay ◽

Healthy Controls ◽

Blood Samples ◽

Igm Antibodies ◽

Stage Renal Disease ◽

End Stage

AbstractInfection is a significant cause of morbidity and mortality in patients with chronic kidney disease, especially who were under dialysis due to their depressed immunity. Toxoplasma gondii is a ubiquitous parasite that causes severe manifestations in immunocompromised patients. This case-control study was conducted to the immunodiagnosis and molecular validation of T. gondii infection among patients with end-stage renal disease undergoing haemodialysis. The study population consisted of 260 haemodialysis patients and 259 healthy controls referred to the main dialysis centres of Tehran, Iran during 2016. Anti-T. gondii immunoglobulin G (IgG) and immunoglobulin M (IgM) antibodies were assessed using enzyme-linked immunosorbent assay. As well, the T. gondii genomic DNA in whole blood samples of IgM-positive patients and healthy controls was evaluated using GRA6-polymerase chain reaction (PCR) and SAG1-loop-mediated isothermal amplification (LAMP) assays. The anti-T. gondii IgG and IgM antibodies were detected in 175 (67.3%) and 18 (7%) of haemodialysis patients and 122 (47%) and 4 (1.5%) of controls, respectively. Two of the 18 blood samples from IgM-positive patients and none of the IgM-positive control subjects were positive by GRA6-PCR. Whereas, nine and two blood samples of IgM-positive patients and controls were positive for Toxoplasma DNA by a SAG1-LAMP technique respectively. The seropositivity of the Toxoplasma IgM antibody was significantly different between haemodialysis patients and healthy controls which was confirmed by PCR and LAMP. The higher prevalence of T. gondii infection in haemodialysis patients compared with the controls proposes that these patients can be a group at risk for toxoplasmosis and screening for toxoplasmosis before dialysis is necessary for the patients.

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Removal of Dolutegravir by Hemodialysis in HIV-Infected Patients with End-Stage Renal Disease

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.03131-15 ◽

2016 ◽

Vol 60 (4) ◽

pp. 2564-2566 ◽

Cited By ~ 7

Author(s):

José Moltó ◽

Fredzzia Graterol ◽

Cristina Miranda ◽

Saye Khoo ◽

Ioana Bancu ◽

...

Keyword(s):

Renal Disease ◽

Protein Binding ◽

End Stage Renal Disease ◽

Inhibitory Concentration ◽

Plasma Concentrations ◽

Extraction Ratio ◽

Dialysis Session ◽

Registration Number ◽

Stage Renal Disease ◽

End Stage

ABSTRACTData on dolutegravir removal by hemodialysis are lacking. To study this, we measured dolutegravir plasma concentrations in samples of blood entering and leaving the dialyzer and of the resulting dialysate from 5 HIV-infected patients with end-stage renal disease. The median dolutegravir hemodialysis extraction ratio was 7%. The dolutegravir concentrations after the dialysis session remained far above the protein-binding-adjusted inhibitory concentration. Our results show minimal dolutegravir removal by hemodialysis, with no specific dolutegravir dosage adjustments required in this setting. (This study is registered at ClinicalTrials.gov under registration number NCT02487706.)

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