What Do We Know About XXXX Metabolism and 'PK/PD Approach' in AKI and CKD Especially While on RRT - Current Status in 2014.

@entity1 @entity8 @entity229 @entity134 @entity230 @entity13507 @entity617
The knowledge on PK behavior of @entity134 drugs such as @entity617 or @entity229 has indeed been expanding but at a rather slow pace. First, convenient, rapid, and specific determination of plasma levels of these @entity230 was largely indebted to the breakthrough of high performance liquid chromatography (HPLC). Second, @entity617 is non-linearly protein-bound. Since unbound @entity617 is the biologically active compound, only the measurement of this free fraction in plasma is relevant. Third, the short half-life of @entity617 precludes to reach steady-state levels and requires determination of the area under the concentration-time curve. Fourth, @entity617 and @entity229 are mutually convertible. Intravenous @entity617 , however, is administered as a pro-drug @entity13507 , which renders comparison and interpretation of reported PK data of both agents unreliable. A poignant lack of awareness and knowledge regarding catabolism, clearance mechanisms, and elimination route of @entity230 fuels the ongoing controversy that surrounds adjunctive corticosteroid therapy in @entity1 with chronic or acute inflammatory disease. This particular @entity1 population is also more prone to develop early and significant @entity8 , necessitating extra-renal support. A better understanding of @entity134 PK/PD, preferentially guided by HPLC measurement of plasma @entity134 concentrations, likely will have direct clinical implications, for instance by adapting @entity134 doses in IHD or implementing higher dose regimens during CRRT.    2014 S. Karger AG, Basel.
