:Comparison among Healthy Volunteers, Patients with Renal Failure and Patients with Liver Cirrhosis

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Serum concentrations, urinary excretion and diuretic effect of piretanide werestudied in 9 subjects (3 healthy volumteers, 3 patients with chronic renal failure and 3 patients with liver cirrhosis) after a single 6mg oral dose. The following results were obtained: (1) Peak serum concentrations of piretanide were attained within 2 hours after treatment in all subjects. Peak serum concentrations and the AUC of the serum concentration curve did not indicate any marked inter-subject variations in absorption. (2) The disappearance of piretanide from the serum was prolonged in patients with reduced renal function. After 24 hours, however, no appreciable amounts of piretanide were detected, even in patients with chronic renal failure. (3) Urinary piretanide excretion was generally completed within 24 hours after treatment in all three groups. The excretion in the renal failure group was, however, lower than in the other two groups. (4) 24-hour urine volumes were comparable in all three groups. Electrolyte (Na+, K+, Cl-), creatinine and uric acid excretion was lower in the renal failure group. (5) In the healthy volunteer and liver cirrhosis groups, serum concentrations and urinary excretion of piretanide both closely reflected diuretic effect. In the renal failure group, diuretic activity was only correlated with urinary excretion of piretanide and not with serum concentrations of drug.
一般社団法人日本臨床薬理学会の論文