Köhler H, Weihrauch T R, Fiegel P, Kirch W, Höffler D
Klin Wochenschr. 1975 Jun 1;53(11):523-7. doi: 10.1007/BF01468757.
In 24 patients on regular hemodialysis the serum levels and the half-life of dextran 40 were determined after single or repeated infusion of dextran 40 (Rheomacrodex¿). One group of hemodialysis trainees had a dextran 40 half-life of 2237 +/- 447 min. In contrast, a second group, consisting of hospital dialysis patients, had a dextran 40 half-life of 4283 +/- 510 min, whereas patients with normal renal function had a half-life of 573 +/- 183 min. The difference in dextran half-life between the two groups of hemodialysis patients may be explained by the better residual renal function of our hemodialysis trainees. During hemodialysis no change in serum dextran levels could be observed. Intermitten hemodialysis, also, had no influence on the exponential elimination of dextran over a period of 6.25 days. Since hemodialysis by itself has no effect upon dextran elimination, the dosage fo dextran 40 has to be adjucted to the prolonged elimination time only, disregarding dialysis. After the fourth infusion of 50 g dextran 40 (twice a week 500 ml of 10% dextran 40) serum dextran levels exceeding 50 g/l and cutaneous bleeding were observed. To avoid these complications an initial saturation dose is suggested, followed by a maintenance dose adjusted to the impaired renal function.
在24例接受定期血液透析的患者中，单次或重复输注右旋糖酐40（Macrodex®）后，测定了血清水平和右旋糖酐40的半衰期。一组血液透析实习生的右旋糖酐40半衰期为2237±447分钟。相比之下，由医院透析患者组成的第二组，右旋糖酐40半衰期为4283±510分钟，而肾功能正常的患者半衰期为573±183分钟。两组血液透析患者右旋糖酐半衰期的差异可能是由于我们的血液透析实习生残余肾功能较好。血液透析期间，血清右旋糖酐水平未见变化。间歇性血液透析在6.25天内对右旋糖酐的指数消除也没有影响。由于血液透析本身对右旋糖酐消除没有影响，因此右旋糖酐40的剂量只需根据延长的消除时间进行调整，而无需考虑透析。在第四次输注50克右旋糖酐40（每周两次，500毫升10%右旋糖酐40）后，观察到血清右旋糖酐水平超过50克/升和皮肤出血。为避免这些并发症，建议先给予饱和剂量，然后根据受损肾功能调整维持剂量。
