Pharmacokinetics of cis-diammine-dichlor-platin in a hemodialysis patient

Cisplatin (CDDP) was administered to a 49-year-old dialysis female patient with advanced uterine cervical cancer. Analysis of the pharmacokinetics of CDDP in the patient with renal failure and at hemodialysis were compared with that of patients without renal impairment. CDDP at 30 mg was administered by drip infusion. The samples were ultrafiltrated and measured its concentration of both free (F-P) and total CDDP (T-P) by atomic absorption method. The effect of hemodialysis on the concentration of CDDP was analyzed. For the control, three patients without renal impairment were administered CDDP using the same method and its concentration was measured. The T-P clearance registered no difference between dialysis patients and controls, but F-P clearance in the HD patient was almost 5-fold lower than those in control patients, showing that F-P exposure to HD patients was 5-fold greater as a consequence of delayed disposition. The protein binding rate of CDDP was more gradual than that of the controls. The T-P and F-P removal rates positively correlated to the shunt side blood F-P.