PHARMACOKINETICS OF ETHANOL IN PATIENTS WITH RENAL-FAILURE BEFORE ANDAFTER HEMODIALYSIS

Authors
Citation
Aw. Jones et Rg. Hahn, PHARMACOKINETICS OF ETHANOL IN PATIENTS WITH RENAL-FAILURE BEFORE ANDAFTER HEMODIALYSIS, Forensic science international, 90(3), 1997, pp. 175-183
Citations number
29
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Medicine, Legal
ISSN journal
0379-0738
Volume
90
Issue
3
Year of publication
1997
Pages
175 - 183
Database
ISI
SICI code
0379-0738(1997)90:3<175:POEIPW>2.0.ZU;2-4
Abstract
We studied the pharmacokinetics of ethanol in seven patients suffering from terminal renal failure before and after they underwent hemodialy sis. Ethanol (0.40 g/kg) was administered in the morning after an over night fast by a constant rate intravenous (IV) infusion over 45 min. A fter removing a mean fluid volume of 2.46+/-0.48 liters (+/-SD), span 1.76-3.43 liters by hemodialysis, the same subjects received a second IV infusion of ethanol after they had eaten lunch. At exactly timed in tervals of 0, 45, 90, 105, 120, 135, 150, 165, and 180 min from the st art of the infusion, two blood-samples were drawn and the plasma porti on of one of them was obtained by centrifugation. The concentration of ethanol in blood and plasma was determined by headspace gas chromatog raphy and the water-content of whole blood was determined from the cha nge in weight after desiccation. Plasma always contained a higher conc entration of ethanol than whole blood and the mean plasma/whole blood ratio in patients with renal failure was 1.07:1 (span 1.05-1.10). The rate of ethanol disappearance from blood (beta-slope) was faster (0.18 5+/-0.013 versus 0.157+/-0.022 g/l/h), the C-0 value was higher (0.79/-0.08 versus 0.73+/-0.10 g/l) and the apparent volume of distribution (V-d) of ethanol was lower (0.507+/-0.049 versus 0.558+/-0.078 l/kg) after hemodialysis. The water content of whole blood was significantly higher (P<0.001) before dialysis (88.6+/-1.97 g/100 ml) compared with after dialysis (87.4+/-2.01 g/100 ml). The higher V-d for ethanol and lower C-0 as well as higher blood-water content are to be expected fo r a over hydrated condition before hemodialysis. The swifter rate of e thanol elimination from blood (beta-slope) after hemodialysis should b e interpreted with caution because eating a meal before the second inf usion of ethanol is a confounding factor. Nevertheless, the rate of el imination of ethanol from blood in patients with renal failure agreed reasonably well with values expected for healthy subjects, namely mean 0.15 g/l/h spanning from 0.10 to 0.20 g/l/h. (C) 1997 Elsevier Scienc e Ireland Ltd.