功能障碍对二皮里米丁脱酶 (DPD) 现型定型的影响
B Royer1, M Launay2, J Ciccolini3
1Laboratoire de Pharmacologie Clinique et Toxicologie, CHU Besançon, Besançon; Univ. Franche-Comté, INSERM, EFS BFC, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, Besançon.
使用 uracilemia 的二皮利米丁脱酶 (DPD) 缺乏症测试在功能障碍患者中可能会产生误导性. 尿素水平和DPD缺乏症的风险在透析后或功能改善后显著下降.
科学领域:
- 药物基因组学 药物基因组学
- 临床化学 临床化学
背景情况:
- 二皮里米丁脱酶 (DPD) 会代谢5-甲 (5-FU),而DPD缺乏会导致严重的毒性.
- 通过 uracilemia 进行 DPD 缺陷测试在法国是强制性的,并在欧洲推使用.
- 功能障碍是一个新发现的因素,可以影响尿素度和DPD表型.
研究的目的:
- 调查功能对尿血症和DPD表型的影响.
- 探索透析和测量膜过率 (mGFR) 对 uracilemia 和 DPD 表型的影响.
- 评估功能变化如何影响患者的尿血症和DPD表型.
主要方法:
- 分析了来自法国三个中心的3039个样本.
- 评估功能障碍严重程度 (eGFR,mGFR) 与尿素血症之间的相关性.
- 在透析前和之后,以及在过渡性功能障碍期间, uracilemia 和 DPD 表型的比较.
主要成果:
- 尿素和DPD缺陷表型随着功能障碍的严重程度增加,比肝功能更为关键.
- 在透析前测试时,患有功能障碍或透析的患者被归类为DPD缺陷的风险更高.
- 在透析 (86.4%至13.7%) 和功能恢复 (83.3%至16.7%) 后,DPD缺乏率显著下降.
结论:
- 在患有功能障碍的患者中,基于尿素血的DPD缺乏测试可能会误导.
- 建议在过渡性功能障碍的情况下重新评估尿血症.
- 透析患者的DPD缺陷测试应在透析后进行;对于 uracil 和功能障碍升高的患者,建议对5-FU 治疗药物进行监测.
更多相关视频
07:35Use of Ultra-high Field MRI in Small Rodent Models of Polycystic Kidney Disease for In Vivo Phenotyping and Drug Monitoring
Published on: June 23, 2015
09:40Isolation, Characterization, And High Throughput Extracellular Flux Analysis of Mouse Primary Renal Tubular Epithelial Cells
Published on: June 20, 2018
相关概念视频
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...
Factors Affecting Renal Clearance: Renal Impairment
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
Renal Drug Excretion: Effect of Urine pH, Flow Rate, and Drug pKa
The pKa of a...
Renal Drug Excretion: Overview
A nephron consists of two primary structures: the renal corpuscle and the renal tubule. The renal corpuscle contains the glomerulus, a network of capillaries where the first step of renal excretion, glomerular filtration, occurs. Blood pressure forces water, ions, and small molecules...
Renal Drug Clearance: Overview
Renal clearance can be calculated using different methods. One approach is to divide the urinary drug excretion rate by the plasma drug concentration. This method directly measures renal clearance, indicating the kidneys' efficiency in...
Serum Studies: Renal Function Tests
