The effect of chronic renal failure on hepatic drug metabolism and drug disposition.

Abstract:

:There is abundant evidence that chronic renal failure (CRF) and end-stage renal disease (ESRD) alter drug disposition by affecting protein and tissue binding and reducing systemic clearance of renally cleared drugs. What is not fully appreciated is that CRF can significantly reduce nonrenal clearance and alter the bioavailability of drugs predominantly metabolized by the liver. Animal studies in CRF have shown a major down-regulation (40-85%) of hepatic cytochrome P-450 metabolism involving specific isozymes. Phase II reactions such as acetylation and glucuronidation are also involved, with some isozymes showing induction and others inhibition. Hepatic enzymes exhibiting genetic polymorphisms such as N-acetyl-transferase-2 (NAT-2), which is responsible for the rapid and slow acetylator phenotypes, have been shown to be inhibited by ESRD and reversed by transplantation. There is some evidence pointing to the possibility of inhibitory factors circulating in the serum in ESRD patients which may be dialyzable. This review includes all significant animal and clinical studies using the search terms "chronic renal failure,"cytochrome P-450," and "liver metabolism" over the past 10 years obtained from the National Library of Medicine MEDLINE database, including relevant articles back to 1969.

journal_name

Semin Dial

journal_title

Seminars in dialysis

authors

Dreisbach AW,Lertora JJ

doi

10.1046/j.1525-139x.2003.03011.x

subject

Has Abstract

pub_date

2003-01-01 00:00:00

pages

45-50

issue

1

eissn

0894-0959

issn

1525-139X

pii

3011

journal_volume

16

pub_type

杂志文章,评审
  • Sympathetic nervous system function and dysfunction in chronic hemodialysis patients.

    abstract::Adequate sympathetic nervous system activation is essential for the compensatory mechanisms of blood pressure maintenance during the hemodialysis (HD) procedure. Chronic sympathetic nervous system overactivity, however, may lead to the development of hypertension and cardiovascular disease in HD patients. The present ...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/sdi.12093

    authors: Rubinger D,Backenroth R,Sapoznikov D

    更新日期:2013-05-01 00:00:00

  • Uremia-related metabolic cardiac risk factors in chronic kidney disease.

    abstract::Growing evidence has been gathered over the last 15 years regarding the role of nontraditional or uremia-related risk factors in the pathogenesis of atherosclerosis in subjects with renal failure. Among those factors, dyslipidemia, inflammation, hyperhomocysteinemia, and oxidant stress have been extensively studied. H...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1046/j.1525-139x.2003.16031.x

    authors: Madore F

    更新日期:2003-03-01 00:00:00

  • In-center hemodialysis education: Challenges and innovations in training of fellows in nephrology.

    abstract::The in-center dialysis unit and practice of dialysis, in the current multi-team approach, requires knowledge and skills in all the domains including medical expert, communicator, collaborator, scholar, health advocate, and leader. We are tasked as a community, to embrace and incentivize new innovations and technology ...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章

    doi:10.1111/sdi.12668

    authors: Moist LM,Lindsay RM

    更新日期:2018-03-01 00:00:00

  • Endotoxemia in end-stage kidney disease.

    abstract::Chronic unexplained inflammation remains a prevalent and clinically significant problem for patients with end-stage kidney disease (ESKD), especially in the dialysis population. The causes of persistent inflammation are likely to be multifactorial, but the underlying mechanisms remain to be elucidated. Endotoxins are ...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/sdi.12280

    authors: Wong J,Vilar E,Farrington K

    更新日期:2015-01-01 00:00:00

  • Sources of Mortality on Dialysis with an Emphasis on Microemboli.

    abstract::Patients on chronic hemodialysis have a shortened survival compared to the general population. There are multiple sources of morbidity and mortality unique to the dialysis population that account for this. Reasons include the effects of blood membrane interactions, intradialytic hypotension, myocardial stunning, exces...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/sdi.12527

    authors: Stegmayr BG

    更新日期:2016-11-01 00:00:00

  • Comparison of peritoneal dialysis catheter insertion techniques by nephrologists: Surgical vs blind methods.

    abstract:BACKGROUND:The aim of the present study was to perform a comparative analysis of peritoneal dialysis catheter (PDC) insertion between blind and surgical methods by nephrologists. PATIENTS AND METHODS:The present study enrolled 249 peritoneal dialysis patients who received first-time PDC insertion. All PDC insertions w...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章

    doi:10.1111/sdi.12904

    authors: Kang SH,Park JW,Cho KH,Do JY

    更新日期:2020-07-23 00:00:00

  • Fatigue in chronic dialysis patients.

    abstract::Fatigue is common in chronic hemodialysis (HD) patients and impacts on daily living, impairs significantly the quality of life, increases the risk of cardiovascular events and negatively influences survival. Although numerous social, demographic, clinical, and laboratory variables have been associated with fatigue, th...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/j.1525-139X.2011.00956.x

    authors: Bossola M,Vulpio C,Tazza L

    更新日期:2011-09-01 00:00:00

  • Dialysis-related amyloidosis: pathogenesis focusing on AGE modification.

    abstract::Dialysis-related amyloidosis (DRA) is a serious complication in long-term dialysis patients, and presents with carpal tunnel syndrome, cystic bone lesions, destructive spondylarthropathy, diffuse arthritis and periarthritis, systemic organ involvement, and dialysis-related spinal canal stenosis (DSCS). Recently a new ...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1046/j.1525-139x.2001.00031.x

    authors: Niwa T

    更新日期:2001-03-01 00:00:00

  • Immunosuppressive management of dialysis patients with recently failed transplants.

    abstract::Over the past decade, patients returning to dialysis after a failed transplant comprised of 5-10% of the annual number of dialysis initiations in the United States, whereas retransplant candidates account for 5.0-13% of the annual deceased donor wait-list additions. The United States Renal Data System (USRDS) database...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/j.1525-139X.2011.00864.x

    authors: Pham PT,Pham PC

    更新日期:2011-05-01 00:00:00

  • Withholding and withdrawal from dialysis: what we know about how our patients die.

    abstract::Withholding and withdrawal of dialysis has been a reality since dialysis was invented. Only in the past 20 years has it been formally studied, and we still have a great deal to learn. The nephrology community has slowly come to accept that, for some of our patients, not having dialysis is a better option than continui...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/j.1525-139X.2007.00273.x

    authors: Germain MJ,Cohen LM,Davison SN

    更新日期:2007-05-01 00:00:00

  • We Use Heparin as the Anticoagulant for CRRT.

    abstract::Continuous Renal Replacement Therapy (CRRT) usually requires anticoagulation to prevent clotting of the extracorporeal circuit. Interruptions due to filter clotting significantly reduce total therapy time and CRRT efficacy. Although heparin has traditionally been the most common anticoagulant used for CRRT, increasing...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章

    doi:10.1111/sdi.12503

    authors: Karakala N,Tolwani A

    更新日期:2016-07-01 00:00:00

  • Fluid mechanics and clinical success of central venous catheters for dialysis--answers to simple but persisting problems.

    abstract::Over 60% of patients initiating chronic hemodialysis in the United States have a chronic central venous catheter (CVC) as their first blood access device. Although it would be better if these patients started dialysis with fistulas, the CVC is used because it is a reliable and relatively safe method for obtaining bloo...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/j.1525-139X.2007.00284.x

    authors: Ash SR

    更新日期:2007-05-01 00:00:00

  • Oral iron for patients receiving dialysis: what is the evidence?

    abstract::This review aims to summarize the available evidence of the effectiveness of oral iron in patients receiving dialysis. Four small randomized controlled trials (105 evaluated patients) compared oral iron supplements with placebo or no treatment; hemoglobin and ferritin levels did not differ significantly between groups...

    journal_title:Seminars in dialysis

    pub_type: 社论,评审

    doi:10.1111/sdi.12149

    authors: Hodson EM,Craig JC

    更新日期:2014-01-01 00:00:00

  • A novel technique for tethered dialysis catheter removal using the laser sheath.

    abstract::Traction and cutdown techniques can successfully remove a tunneled dialysis catheter (TDC) in a great majority of patients. However, these methods may not be successful in patients with catheters that are tethered or attached to the central veins or the atrium. A forceful application of traction can lead to catheter b...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章

    doi:10.1111/j.1525-139X.2009.00646.x

    authors: Carrillo RG,Garisto JD,Salman L,Merrill D,Asif A

    更新日期:2009-11-01 00:00:00

  • Antidiabetic Therapy in End-Stage Renal Disease.

    abstract::There has been substantial growth in the variety of available antidiabetic agents during the last decade and a half. The role of these newer agents in patients with diabetes and end-stage renal disease (ESRD) population, and their relative benefits and risks in this population compared to patients without ESRD are not...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/sdi.12368

    authors: Boyle SM,Simon B,Kobrin SM

    更新日期:2015-07-01 00:00:00

  • Perioperative management of the hemodialysis patient.

    abstract::Dialysis-dependent chronic kidney disease (CKD) is an expanding problem for healthcare systems worldwide. The prevalence of end-stage renal disease (ESRD) has increased by 20% since 2000 and stands at 1699 per million people in the USA. ESRD is associated with an increased risk of cardiovascular comorbidity, increased...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/j.1525-139X.2011.00856.x

    authors: Trainor D,Borthwick E,Ferguson A

    更新日期:2011-05-01 00:00:00

  • Doppler ultrasound: a powerful tool for vascular access surveillance.

    abstract::National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NKF KDOQI) guidelines recommend Doppler ultrasound (DU) for surveillance of vascular access (VA), but trials have not been unanimous about its benefit on VA patency. The aim of this study was to evaluate the accuracy of DU for patency, as well as t...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章

    doi:10.1111/sdi.12334

    authors: Guedes Marques M,Ibeas J,Botelho C,Maia P,Ponce P

    更新日期:2015-03-01 00:00:00

  • Drug therapy for hypertension in hemodialysis patients.

    abstract::The majority of end-stage renal disease (ESRD) patients are hypertensive. Drug therapy for hypertension in hemodialysis (HD) patients includes all classes of antihypertensive drugs, with the sole exception of diuretics. Angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers may decrease mo...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/j.0894-0959.2004.17329.x

    authors: Hörl MP,Hörl WH

    更新日期:2004-07-01 00:00:00

  • Iatrogenic Baclofen Neurotoxicity in ESRD: Recognition and Management.

    abstract::Baclofen is an oral derivative of gamma-aminobutyric acid (GABA) used to treat muscular spasticity from disorders of the central nervous system. However, it is also being used for a variety of other conditions such as musculoskeletal pain, myoclonus, and alcohol withdrawal. The elimination of baclofen is heavily depen...

    journal_title:Seminars in dialysis

    pub_type: 信件

    doi:10.1111/sdi.12400

    authors: Roberts JK,Westphal S,Sparks MA

    更新日期:2015-09-01 00:00:00

  • Intradialytic hypotension: an overview of recent, unresolved and overlooked issues.

    abstract::The etiology and management of intradialytic hypotension has become an increasingly complex issue. Volume depletion due to ultrafiltration remains the predominant underlying etiologic factor. However, patients vary markedly in their hemodynamic tolerance to fluid removal. While many risk factors have been identified, ...

    journal_title:Seminars in dialysis

    pub_type: 社论,评审

    doi:10.1046/j.1525-139x.2002.00002.x

    authors: Sherman RA

    更新日期:2002-05-01 00:00:00

  • Improving hemodialysis patient outcomes: a step-by-step approach.

    abstract::Hemodialysis patient outcomes are often suboptimal, with one-sixth of patients receiving an inadequate dialysis dose, one-fourth using catheters for vascular access, and more than one-half being malnourished. This review describes a four-step approach for improving dialysis patient outcomes. First, select an outcome t...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1046/j.1525-139x.2002.00013.x

    authors: Sehgal AR

    更新日期:2002-01-01 00:00:00

  • The failed renal transplant: in or out?

    abstract::With the increased number of renal transplants being performed in the United States, there are also increasing numbers of early and long-term allograft failures. Patients with failed allografts require reentry into the end-stage renal disease (ESRD) system. If an allograft is producing little in the way of morbidity, ...

    journal_title:Seminars in dialysis

    pub_type: 社论,评审

    doi:10.1111/j.1525-139X.2005.18306.x

    authors: Bennett WM

    更新日期:2005-05-01 00:00:00

  • Dialysis vascular access management by interventional nephrology programs at University Medical Centers in the United States.

    abstract::The development of interventional nephrology has undoubtedly led to an improvement in patient care at many facilities across the United States. However, these services have traditionally been offered by interventional nephrologists in the private practice arena. While interventional nephrology was born in the private ...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章

    doi:10.1111/j.1525-139X.2011.00985.x

    authors: Vachharajani TJ,Moossavi S,Salman L,Wu S,Dwyer AC,Ross J,Dukkipati R,Maya ID,Yevzlin AS,Agarwal A,Abreo KD,Work J,Asif A

    更新日期:2011-09-01 00:00:00

  • an Obituary for GFR as the main marker for kidney function?

    abstract::This publication comments on the recently published findings of a study by Eloot et al. (cJASN, 6: 1266-1273, 2011) that evaluated the correlation between several formulae for calculating estimated GFR (eGFR) and different low molecular weight uremic toxins; eGFRs were based on serum creatinine (SCrea), cystatin C (Cy...

    journal_title:Seminars in dialysis

    pub_type: 社论

    doi:10.1111/j.1525-139X.2011.01003.x

    authors: Vanholder R,Eloot S,Schepers E,Neirynck N,Glorieux G,Massy Z

    更新日期:2012-01-01 00:00:00

  • Cardiovascular disease in chronic renal failure: pathophysiologic aspects.

    abstract::Cardiovascular complications are the leading cause of mortality in patients with end-stage renal disease (ESRD). The excess cardiovascular risk and mortality is already demonstrable in early renal disease and in patients with chronic renal failure (CRF), with the highest relative risk of mortality in the youngest pati...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1046/j.1525-139x.2003.16023.x

    authors: London GM

    更新日期:2003-03-01 00:00:00

  • Renal osteodystrophy, phosphate homeostasis, and vascular calcification.

    abstract::New advances in the pathogenesis of renal osteodystrophy (ROD) change the perspective from which many of its features and treatment are viewed. Calcium, phosphate, parathyroid hormone (PTH), and vitamin D have been shown to be important determinants of survival associated with kidney diseases. Now ROD dependent and in...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/j.1525-139X.2007.00300.x

    authors: Hruska KA,Saab G,Mathew S,Lund R

    更新日期:2007-07-01 00:00:00

  • Acidosis in chronic renal insufficiency.

    abstract::In this article we deal with three aspects of acidosis in patients with chronic renal insufficiency: clinical characteristics, pathophysiology, and therapeutic approach. ...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1046/j.1525-139x.2000.00064.x

    authors: Uribarri J

    更新日期:2000-07-01 00:00:00

  • Management of the Dialysis Patient with Sickle Cell Disease.

    abstract::While patients with sickle cell disease currently constitute a very small minority of the US dialysis population (0.1%), there is anticipated growth of this group as the life expectancy of those with sickle cell disease (SCD) increases. SCD patients suffer a high burden of morbidity, which is enhanced by the presence ...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/sdi.12403

    authors: Boyle SM,Jacobs B,Sayani FA,Hoffman B

    更新日期:2016-01-01 00:00:00

  • The medical-legal responsibilities of a dialysis unit medical director.

    abstract::The specialty of Nephrology, by virtue of its relationship with the dialysis procedure, is highly vulnerable to litigation. As is the case with all nephrologists, a dialysis unit medical director is not immune to medical malpractice suits, and can be held liable for any act of perceived or potential harm to any dialys...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/sdi.12174

    authors: Vaqar S,Murray B,Panesar M

    更新日期:2014-09-01 00:00:00

  • What is so bad about reverse epidemiology anyway?

    abstract::The term "reverse epidemiology" is used to indicate that such surrogates of cardiovascular risk and metabolic syndrome as obesity, hypercholesterolemia and hypertension are paradoxically associated with greater survival in individuals with chronic disease states and wasting, including dialysis patients, in whom the sh...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/j.1525-139X.2007.00360.x

    authors: Kalantar-Zadeh K

    更新日期:2007-11-01 00:00:00