估计的膜过速率方程对卡博普拉丁剂量的影响:一个真实世界的研究
Ana Rita Fortunato1, Cátia Barbosa1, Ariana Araujo1
1Pharmacy Department, ULS Alto Ave, Guimarães, Portugal.
Frontiers in pharmacology
|June 26, 2025
概括
从Coccroft-Gault (CG) 转换到慢性病流行病学协作 (CKD-EPI) 的卡博普拉丁剂量计算导致了显著的剂量差异. 这些变化,特别是在低BMI的男性患者中,需要仔细考虑准确的抗瘤药物管理.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 在瘤学瘤学.
- 药理动力学 药理动力学
背景情况:
- 卡博普拉丁是一种通过脏分泌的抗瘤药物,与骨髓毒性作用有关.
- 剂量依赖于卡尔维特公式,该公式利用估计的膜过率 (eGFR).
- 对于eGFR,从Cockcroft-Gault (CG) 转向无种族CKD-EPI方程的潜在转变可能会影响碳白金剂量.
研究的目的:
- 评估使用CKD-EPI方程与CG方程对碳白金剂量的影响.
- 在现实环境中,根据从两个不同的方程中计算的eGFR计算,分析卡博普拉丁剂量的差异.
主要方法:
- 追溯分析2023年从医院瘤日间护理单位给出的487次卡博普拉丁药物.
- 使用CKD-EPI基于原始CG计算的eGFR估计重新计算卡博普拉丁剂量.
- 布兰德-阿尔特曼分析以评估差异,以及与人类学数据的相关性分析.
主要成果:
- 在CG和CKD-EPI eGFR计算之间观察到显著的平均差异 (p < 0.001).
- CKD-EPI导致了更高的平均碳酸剂量 (52毫克更高),百分比差异从-24.3%到+70.9%.
- 剂量差异与体重指数 (BMI) 有很强的相关性 (R = 0.681,p < 0.001).
结论:
- 在使用CG与CKD-EPI方程式计算的卡博普拉丁剂量中存在临床相关的差异.
- 这些差异在男性患者中更为明显,BMI较低.
- 这些发现强调了需要重新评估剂量协议,并采用CKD-EPI来计算eGFR.
相关概念视频
01:11Renal Failure: Dose Adjustments
167
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...
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...
167
01:02Renal Drug Excretion: Glomerular Filtration
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The kidney serves as the primary organ responsible for eliminating drugs and their metabolites from the body. This process, known as renal elimination, starts with glomerular filtration and results in urine formation. Each kidney houses millions of functional units called nephrons, where urine production occurs. A nephron has two main components: a renal corpuscle and a renal tubule.
Drugs gain access to the kidney via the renal artery, which progressively branches off into afferent arterioles....
Drugs gain access to the kidney via the renal artery, which progressively branches off into afferent arterioles....
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01:08Renal Drug Clearance: Comparison Between Renal Excretion Methods
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Renal clearance is a critical parameter encompassing kidney filtration, secretion, and reabsorption processes. It is calculated using a specific equation to determine the rate at which the kidneys clear a drug.
Renal clearance is often associated with the renal glomerular filtration rate (GFR), which represents the rate at which plasma is filtered through the glomeruli in the kidney. When drug reabsorption is minimal and there is no active secretion, renal clearance is closely related to the...
Renal clearance is often associated with the renal glomerular filtration rate (GFR), which represents the rate at which plasma is filtered through the glomeruli in the kidney. When drug reabsorption is minimal and there is no active secretion, renal clearance is closely related to the...
298
01:17Factors Affecting Renal Clearance: Renal Impairment
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Renal dysfunction significantly impairs the renal clearance of drugs, leading to potential complications in drug therapy. Renal failure, which can be caused by various factors, poses a significant challenge in the elimination of drugs from the body.
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...
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166
01:07Determination of Renal Drug Clearance: Graphical and Midpoint Methods
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Renal clearance, a crucial parameter in pharmacokinetics, can be determined using two different methods: the graphical method and the midpoint method. These methods provide insights into the rate of drug excretion by the kidneys and aid in assessing renal function.
The graphical method involves plotting the rate of drug excretion in urine against the plasma drug concentration. By analyzing the graph, the clearance can be calculated and obtained. Drugs rapidly excreted by the kidneys exhibit a...
The graphical method involves plotting the rate of drug excretion in urine against the plasma drug concentration. By analyzing the graph, the clearance can be calculated and obtained. Drugs rapidly excreted by the kidneys exhibit a...
208
01:22Renal Drug Excretion: Effect of Urine pH, Flow Rate, and Drug pKa
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The pH of urine, the drug's pKa, and the urine flow rate are vital parameters for drug reabsorption and excretion. Urinary pH varies between 4.6 and 8.0 and is influenced by diet, drug intake, and the patient's pathophysiology. It affects a drug's ionization state and reabsorption. For instance, carbohydrate-rich food produces alkaline urine promoting drug excretion, while proteins and certain medications like ascorbic acid lead to acidic urine enhancing reabsorption.
The pKa of a...
The pKa of a...
289