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Related Experiment Videos

Theophylline toxicity risks and chronic renal failure.

G Nicot1, J P Charmes, G Lachatre

  • 1Department of Clinical Pharmacology, Centre Hospitalier Régional Universitaire, Hôpital Dupuytren, Limoges, France.

International Journal of Clinical Pharmacology, Therapy, and Toxicology
|August 1, 1989
PubMed
Summary

Uremic patients show higher serum theophylline metabolites, like 1,3-dimethyluric acid, than non-uremic individuals. This elevation, even with lower theophylline levels, may explain toxicity in patients with chronic renal failure.

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Area of Science:

  • Pharmacokinetics
  • Nephrology
  • Clinical Chemistry

Background:

  • Theophylline is a common medication for respiratory conditions.
  • Uremia can alter drug metabolism and excretion.
  • Theophylline toxicity is a concern in patients with impaired kidney function.

Purpose of the Study:

  • To investigate serum concentrations of theophylline and its metabolites in uremic patients.
  • To compare these concentrations with those in non-uremic subjects.
  • To elucidate the relationship between uremia, theophylline metabolism, and potential toxicity.

Main Methods:

  • High-performance liquid chromatography (HPLC) was used to measure serum concentrations.
  • Uremic patients included those with end-stage renal failure, peritoneal dialysis, and hemodialysis.

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  • Concentrations were compared between uremic and non-uremic patient groups.

    • Main Results:

    • Uremic patients exhibited significantly higher serum theophylline metabolites, especially 1,3-dimethyluric acid, compared to non-uremic subjects.
    • Serum theophylline concentrations were often lower in uremic patients.
    • A slight increase in the free fraction of serum theophylline was observed in uremic individuals.

    Conclusions:

    • Elevated theophylline metabolites in uremia can contribute to toxicity, even at low theophylline doses.
    • Altered metabolism and excretion in chronic renal failure impact theophylline pharmacokinetics.
    • These findings highlight the need for careful monitoring of theophylline therapy in uremic patients.