Related Experiment Video
Updated: Mar 30, 2026

Intravascular Delivery of Biologics to the Rat Kidney
Published on: September 1, 2016
Breakthrough Pain Associated with a Reduction in Serum Buprenorphine Concentration during Dialysis
Ali Reza Salili1, Daniel Müller2, Roswitha Skendaj3
1Department of Clinical Pharmacology and Toxicology, University and University Hospital Basel, Basel, Switzerland; Medical University Department of the University of Basel, Kantonsspital Aarau, Aarau, Switzerland.
Purpose:
To describe a case of breakthrough pain associated with a reduction in serum buprenorphine concentration during dialysis.
Methods:
Pharmacokinetic sampling of total and free buprenorphine and norbuprenorphine in an 80 year old male undergoing haemodialysis three times per week who received 5760 µg oral and transdermal buprenorphine daily was performed. The patient's serum albumin concentration was 23g/l (reference range: 35-52 g/l).
Findings:
Pharmacokinetic sampling revealed a free buprenorphine fraction of 32% (consistent with the hypoalbuminaemia), which was markedly reduced at the end of dialysis (free buprenorphine concentration 2.4 µg/l before vs. <0.1 µg/l after dialysis).
Implications:
Clinicians should be aware that some patients may require extra buprenorphine doses during dialysis to prevent significant falls in the concentration of active drug.
Related Concept Videos
Hemodialysis II: Procedure and Complications
Hemodialysis III: Nursing Management
Dialysis
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
Dialysis
Extracorporeal Removal of Drugs: Peritoneal Dialysis and Hemodialysis
Renal Failure: Dose Adjustments
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...

