Effect of Unilateral Nephrectomy on the Pharmacokinetics of Atenolol in Humans

Unilateral nephrectomy is a common surgical procedure and involves functional adaptation of the remaining kidney. There is a paucity of data addressing whether drugs eliminated predominantly through the urinary tract, such as atenolol, can be effectively handled by unilaterally nephrectomized patien...

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Bibliographic Details
Published in:	Journal of clinical pharmacology Vol. 43; no. 5; pp. 524 - 528
Main Authors:	Drozdzik, Marek, Domanski, Leszek, Wojcicki, Jerzy, Pudlo, Artur, Machoy, Piotr
Format:	Journal Article
Language:	English
Published:	Oxford, UK Blackwell Publishing Ltd 01-05-2003 SAGE Publications Sage Science Wiley Subscription Services, Inc
Subjects:	Adrenergic beta-Antagonists - pharmacokinetics Adult Aging - metabolism Antihypertensive agents Area Under Curve atenolol Atenolol - pharmacokinetics Biological and medical sciences Body Weight - physiology Cardiovascular system Female glomerular filtration rate Half-Life Humans Kidney Function Tests Male Medical sciences Nephrectomy - adverse effects pharmacokinetics Pharmacology. Drug treatments renal function Unilateral nephrectomy Kidney disease Human Urinary system disease Renal function Oral administration Atenolol β1-Adrenergic receptor Nephrectomy Unilateral Antihypertensive agent Antagonist Pharmacokinetics Beta blocking agent
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Summary:	Unilateral nephrectomy is a common surgical procedure and involves functional adaptation of the remaining kidney. There is a paucity of data addressing whether drugs eliminated predominantly through the urinary tract, such as atenolol, can be effectively handled by unilaterally nephrectomized patients. This study was carried out in 28 subjects 1 month (10 subjects) and 1 year (10 subjects) after unilateral nephrectomy, as well as in 8 healthy volunteers who were administered atenolol as a single oral dose of 100 mg. Pharmacokinetic parameters of atenolol were calculated using a one‐compartment open model. It was revealed that atenolol blood serum concentrations were significantly elevated in nephrectomized patients as compared with the control subjects, especially 1 month after the surgery. Patients nephrectomized 1 month prior to the study were characterized by an increase in AUC by 43% (p < 0.05), reduction of Λz by 36% (p<0.001) and CLT by 27% (p < 0.001), and prolongation of t1/2 by 60% (p < 0.001) in comparison with healthy volunteers. The values of atenolol pharmacokinetic parameters in patients 1 year after unilateral nephrectomy did not differ significantly as compared to the controls. However, a trend indicating an impaired elimination was noted. A decrease in Λz by 16%, prolongation of t1/2 by 32%, and reduction of CLT by 32% were observed. The results suggest that unilateral nephrectomy impairs elimination of atenolol and possibly other drugs predominantly eliminated via the kidney.
Bibliography:	ark:/67375/WNG-WZJ8ZZR1-H istex:DA9663B62C5399D822AF61849803B4BECE89C5CD ArticleID:JCPH581 The study protocol was approved by the Pomeranian Academy of Medicine Ethics Committee on human research. The aim of the study was fully explained to all patients, and informed consent was obtained in each case. ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23
ISSN:	0091-2700 1552-4604
DOI:	10.1177/0091270003252498