Cimetidine clearance during intermittent and chronic peritoneal dialysis

A case report evaluating the clearance of cimetidine during intermittent peritoneal dialysis and chronic ambulatory peritoneal dialysis is presented. A 50-year-old white man with end-stage renal disease using chronic ambulatory peritoneal dialysis was hospitalized with uremic pericarditis. He was treated with indomethacin and aggressive intermittent peritoneal dialysis. Cimetidine 300 mg every 12 hours was prescribed for ulcer prophylaxis. After taking cimetidine for seven days, the clearance of cimetidine during intermittent peritoneal dialysis was evaluated by collecting blood and dialysate samples during a four-hour dialysis period. The patient was discharged using chronic ambulatory peritoneal dialysis. Cimetidine 300 mg every 12 hours was continued. One week after discharge, the clearance of cimetidine during a four-hour dwell period of chronic ambulatory peritoneal dialysis was measured. Cimetidine clearance was approximately 4 ml/min for both intermittent and chronic ambulatory peritoneal dialysis. Clinically unimportant quantities of cimetidine were removed by intermittent and chronic ambulatory peritoneal dialysis. The need for supplemental doses of cimetidine during peritoneal dialysis is not supported.