Skip to main content
SpringerLink
Log in

Pharmakotherapie

Pharmacotherapy

  • Leitthema
  • Published:
Der Nephrologe Aims and scope

Zusammenfassung

Für Dialysepatienten wichtige Medikamente sind Antihypertensiva, Antidiabetika, Blutbildungshormone, Osteopathiebehandlung, Cholesterinsenker und Schmerzmedikamente. Lebensentscheidend können Antibiotika und ihre richtige Dosierung sein. Zwei Fragen stellen sich: 1. welches Medikament ist für die jeweilige Indikation zu bevorzugen, und 2. welche Dosis muss man geben. Am Beispiel der Cefazolin-Dosierung werden die Dettli-Regel und die Kunin-Regel der Dosisberechnung erläutert. Dosierungsempfehlungen für Cefazolin bei kontinuierlicher Hämofiltration mit einem Kreatinin von 3,96 mg/dl und bei intermittierender Dialyse werden aus den Regeln abgeleitet.

Abstract

Dialysis patients need drugs for hypertension, diabetes, anemia, osteopathy, cholesterol, and pain. Antimicrobial agents and the correct dose may have vital impact in the intensive care setting. Two questions must be answered: (1) what is the right drug for the symptom and (2) what is the right dose? For the example of cefazolin the Dettli rule and the Kunin rule are illustrated to adjust the dose. Dosage recommendations for cefazolin are given for the case of hemofiltration with a creatinine of 3.96 mg/dl and for the case of anuria and intermittent hemodialysis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1
Abb. 2
Abb. 3

Literatur

  1. Benet LZ, Hoener BA (2002) Changes in plasma protein binding have little clinical relevance. Clin Pharmacol Ther 71: 115–121

    Article  PubMed  CAS  Google Scholar 

  2. Block GA, Raggi P, Bellasi A et al. (2007) Mortality effect of coronary calcification and phosphate binder choice in incident hemodialysis patients. Kidney Int 71: 438–441

    Article  PubMed  CAS  Google Scholar 

  3. Boesler B, Czock D, Keller F et al. (2005) Clinical course of haemodialysis patients with malignancies and dose-adjusted chemotherapy. Nephrol Dial Transplant 20: 1187–1191

    Article  PubMed  CAS  Google Scholar 

  4. Buijk SE, Mouton JW, Gyssens IC et al. (2002) Experience with a once-daily dosing program of aminoglycosides in critically ill patients. Intensive Care Med 28: 936–942

    Article  PubMed  CAS  Google Scholar 

  5. Dettli L (1976) Drug dosage in renal disease. Clin Pharmacokinet 1: 126–134

    PubMed  CAS  Google Scholar 

  6. Ekstrom P, Carling L, Wetterhus S et al. (1996) Prevention of peptic ulcer and dyspeptic symptoms with omeprazole in patients receiving continuous non-steroidal anti-inflammatory drug therapy. A Nordic multicentre study. Scand J Gastroenterol 31: 753–758

    PubMed  CAS  Google Scholar 

  7. Elung-Jensen T, Heisterberg J, Sonne J et al. (2005) Enalapril dosage in progressive chronic nephropathy: a randomised, controlled trial. Eur J Clin Pharmacol 61: 87–96

    Article  PubMed  CAS  Google Scholar 

  8. Elung-Jensen T, Heisterberg J, Kamper AL et al. (2003) Blood pressure response to conventional and low-dose enalapril in chronic renal failure. Br J Clin Pharmacol 55: 139–146

    Article  PubMed  CAS  Google Scholar 

  9. Gago-Dominguez M, Yuan JM, Castelao JE et al. (1999) Regular use of analgesics is a risk factor for renal cell carcinoma. Br J Cancer 81: 542–548

    Article  PubMed  CAS  Google Scholar 

  10. Guan Y, Hao C, Cha DR et al. (2005) Thiazolidinediones expand body fluid volume through PPARgamma stimulation of ENaC-mediated renal salt absorption. Nat Med 11: 861–866

    Article  PubMed  CAS  Google Scholar 

  11. Haubitz M, Bohnenstengel F, Brunkhorst R et al. (2002) Cyclophosphamide pharmacokinetics and dose requirements in patients with renal insufficiency. Kidney Int 61: 1495–1501

    Article  PubMed  CAS  Google Scholar 

  12. Keller F, Griesshammer M, Haussler U et al. (2001) Pregnancy and renal failure: the case for application of dosage guidelines. Drugs 61: 1901–1920

    Article  PubMed  CAS  Google Scholar 

  13. Kunin CM (1967) A guide to use of antibiotics in patients with renal disease. A table of recommended doses and factors governing serum levels. Ann Intern Med 67: 151–158

    PubMed  CAS  Google Scholar 

  14. Labenz J, Blum AL, Bolten WW et al. (2002) Primary prevention of diclofenac associated ulcers and dyspepsia by omeprazole or triple therapy in Helicobacter pylori positive patients: a randomised, double blind, placebo controlled, clinical trial. Gut 51: 329–335

    Article  PubMed  CAS  Google Scholar 

  15. Mihatsch MJ, Khanlari B, Brunner FP (2006) Obituary to analgesic nephropathy–an autopsy study. Nephrol Dial Transplant 21: 3139–3145

    Article  PubMed  Google Scholar 

  16. Ozkahya M, Ok E, Toz H et al. (2006) Long-term survival rates in haemodialysis patients treated with strict volume control. Nephrol Dial Transplant 21: 3506–3513

    Article  PubMed  Google Scholar 

  17. Phakdeekitcharoen B, Leelasa-nguan P (2004) Effects of an ACE inhibitor or angiotensin receptor blocker on potassium in CAPD patients. Am J Kidney Dis 44: 738–746

    Article  PubMed  CAS  Google Scholar 

Download references

Interessenkonflikt

Es besteht kein Interessenkonflikt. Der korrespondierende Autor versichert, dass keine Verbindungen mit einer Firma, deren Produkt in dem Artikel genannt ist, oder einer Firma, die ein Konkurrenzprodukt vertreibt, bestehen. Die Präsentation des Themas ist unabhängig und die Darstellung der Inhalte produktneutral.

Author information

Authors and Affiliations

  1. Sektion Nephrologie,Klinik für Innere Medizin I, Zentrum Innere Medizin,Universitätsklinikum Ulm, Robert-Koch-Straße 8, 89070, Ulm, Deutschland

    C. Aymanns, D. Czock &  F. Keller

Authors
  1. C. Aymanns
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. D. Czock
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. F. Keller
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to F. Keller.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Aymanns, C., Czock, D. & Keller, F. Pharmakotherapie. Nephrologe 2, 270–278 (2007). https://doi.org/10.1007/s11560-007-0090-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11560-007-0090-2

Schlüsselwörter

Keywords

Search

Navigation