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Renal Failure: Dose Adjustments

Renal Failure: Dose Adjustments

In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
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...

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Nerve Excitability Assessment in Chemotherapy-induced Neurotoxicity

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Carnitine Levels Decrease during Oxaliplatin Infusion: A Pilot Study.

Lianne P W van Geffen^1,2, Floortje Mols^3,4, Veerle C M Geurts^1,2

¹Department of Internal Medicine, Máxima Medical Centre, Veldhoven, The Netherlands.

|May 25, 2025

Summary

This summary is machine-generated.

Oxaliplatin chemotherapy significantly decreases carnitine levels in the blood and increases its excretion in urine. This carnitine loss may contribute to chemotherapy-induced peripheral neuropathy (CIPN).

Keywords:

Carnitine Chemotherapy Chemotherapy-induced peripheral neuropathy Oxaliplatin

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Important Endpoints and Proliferative Markers to Assess Small Intestinal Injury and Adaptation using a Mouse Model of Chemotherapy-Induced Mucositis

Important Endpoints and Proliferative Markers to Assess Small Intestinal Injury and Adaptation using a Mouse Model of Chemotherapy-Induced Mucositis

Published on: May 12, 2019

Area of Science:

Oncology
Nephrology
Biochemistry

Background:

Chemotherapy-induced peripheral neuropathy (CIPN) is a frequent, dose-limiting side effect of chemotherapy.
Low carnitine levels are suspected to worsen CIPN, but their dynamic changes during chemotherapy are poorly understood.
Existing carnitine supplementation studies for CIPN prevention show mixed results, possibly due to varied administration timing and routes.

Purpose of the Study:

To investigate the impact of oxaliplatin-based chemotherapy on blood and urinary carnitine levels.
To test the hypothesis that oxaliplatin increases renal carnitine excretion, leading to deficiency and potentially contributing to CIPN.

Main Methods:

An observational pilot study involving ten patients initiating oxaliplatin-based chemotherapy.
Blood and urine samples were collected before, during, and after oxaliplatin infusion.
Primary endpoints included changes in plasma and urinary concentrations of free carnitine and carnitine esters.

Main Results:

A significant reduction in both free carnitine and carnitine esters was observed in plasma two hours post-oxaliplatin infusion.
A trend towards increased urinary carnitine concentration was noted during chemotherapy infusion, though not statistically significant.

Conclusions:

Observed alterations in plasma and urinary carnitine support the hypothesis of oxaliplatin-induced increased renal excretion.
This process may lead to carnitine deficiency over multiple cycles, potentially contributing to CIPN development.
Further large-scale longitudinal studies are necessary to confirm these preliminary findings and their clinical significance.