ACUTE CHANGES IN RENAL-FUNCTION ASSOCIATED WITH DEFEROXAMINE THERAPY
ACUTE CHANGES IN RENAL-FUNCTION ASSOCIATED WITH DEFEROXAMINE THERAPY
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DOI：
10.1001/archpedi.1989.02150210113029
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发表时间：
1989-09-01
影响因子：
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通讯作者：
FREEDMAN, MH
中科院分区：
文献类型：
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作者：
KOREN, G;BENTUR, Y;FREEDMAN, MH
在3例接受静脉注射去铁胺的患者中，血浆肌酐水平增加了2倍至8倍，肌酐清除率平行下降，当停止药物治疗时，肌酐清除率下降。在两个地中海贫血患者，利尿是明显的尿量超过液体摄入量。在静脉注射去铁胺引起的菊糖和对氨基马尿酸清除率急性显著降低的犬中研究了其机制。生理盐水利尿可以防止肾小球滤过率的降低，但不能防止去铁胺引起的肾血流量的减少。去铁胺诱导钠钾、氯化物、磷酸盐和尿酸盐的排泄分数急性增加，这可能解释了在2例患者中观察到的相对利尿。在随后的实验中，铁草胺诱导钠和氯的排泄分数增加，但不影响肾小球滤过率和肾血流量。我们的研究表明，在静脉注射去甲瑞沙明治疗期间，可能需要充分的水合作用来保护肾脏血流动力学。在使用本品治疗的同时，应重复测量肾功能。
In three patients who received intravenous deferoxamine there was a twofold to eightfold increase in plasma creatinine level and a parallel decrease in creatinine clearance that resolved when treatment with the drug was discontinued. In two thalassemic patients, diuresis was evident by urine output exceeding fluid intake. The mechanism was studied in dogs that exhibited an acute and significant decrease in inulin and para-aminohippuric acid clearances induced by intravenous deferoxamine. Saline diuresis could prevent the decrease in the glomerular filtration rate but not the decrease in renal blood flow caused by deferoxamine. Deferoxamine induced an acute increase in the fractional excretion of sodium potassium, chloride, phosphate, and urate, which may explain the relative diuresis observed in two of the patients diuresis observed in two of the patients. In a subsequent experiment, ferrioxamine induced an increase in the fractional excretion of sodium and chloride but did not affect the glomerular filtration rate and renal blood flow. Our studies suggest that adequate hydration may be needed to preserve renal hemodynamics during intravenous defereoxamine therapy. Repeated measurements of renal function should accompany treatment with this agent.