Fabre J, Balant L, Rudhardt M, Blanchard P
Nouv Presse Med. 1979;8(33):2677-82.
Complex pharmacokinetic perturbations follow kidney failure. Delayed excretion affects not only the original substance but also metabolites, as illustrated by the behaviour of glipizide and glibenclamide. Moreover, abnormal absorption, distribution, and metabolism of these drugs also often occur and are particularily evident for some beta-blocking agents. Analysis of tissue pharmacokinetics shows that aminosides accumulate in the renal cortexand persist there for several months. This phenomenon is markedly enhanced in acute obstructive kidney failure and largely accounts for the nephrotoxicity of these drugs.
肾衰竭会引发复杂的药代动力学紊乱。排泄延迟不仅会影响原物质,还会影响代谢产物,格列吡嗪和格列本脲的情况就说明了这一点。此外,这些药物还常常出现吸收、分布及代谢异常,这在某些β受体阻滞剂中尤为明显。组织药代动力学分析表明,氨基糖苷类药物会在肾皮质中蓄积,并在那里持续存在数月。这种现象在急性梗阻性肾衰竭中会显著增强,这也是这些药物具有肾毒性的主要原因。