The effect of impairment of renal function and haemodialysis on serum and urine levels of cephalexin.
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Biomedical subjects
Publications and source records attributed to R R Bailey.
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Intravenous pyelograms done before, during, and after an attack of acute pyelonephritis in a 41-year-old woman showed an increase in the size of both kidneys during the attack. The right kidney did not excrete the contrast medium during the acute episode. When function returned it became smaller, and three months after the attack of pyelonephritis this kidney was 1 cm. shorter than before it.
Suprapubic aspiration of the bladder has proved a safe and reliable method of collecting urine for culture. It avoids contamination of the specimen and dispenses with the need for colony counts, because the isolation of any organism indicates bladder bacteriuria. In addition, urine collected in this way can be kept at 4 degrees C. or at room temperature for up to 10 days before it is cultured.
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Recurrent disseminated intravascular coagulation occurred in 3 women after ingestion of quinine tablets for cramp. All had circulating quinine-dependent antibodies to platelets and in 2 there was initial evidence of antibody consumption, with low titres that rose steeply over the next few days and remained high for many months.
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The single-dose pharmacokinetics of intravenously and orally administered tinidazole were studied in normal subjects and patients with severe chronic renal failure. The clearance of tinidazole was also measured in patients on regular haemodialysis. After intravenous administration the mean elimination half-life of tinidazole was 17.1 +/- 2.3 (SD) hours in the normal subjects and 16.9 +/- 4.9 hours in patients with renal failure; the mean apparent volumes of distribution were 0.80 +/- 0.09 L/kg and 0.69 +/- 0.09 L/kg, respectively. Following oral administration the mean elimination half-life was 15.6 +/- 1.6 hours in the normal subjects and 18.4 +/- 3.5 hours in patients with renal failure; there were no statistically significant differences in these pharmacokinetic parameters. There was no accumulation of the major metabolite (hydroxymethyl tinidazole) in normal subjects or in patients with renal failure. Tinidazole clearance during haemodialysis was 71 +/- 7.7 ml/min. In the presence of renal failure no modification of tinidazole dosage would appear to be necessary. Tinidazole should be administered in full dosage following haemodialysis.
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