Solak Yalcin, Atalay Huseyin, Biyik Zeynep, Alibasic Hayrudin, Gaipov Abduzhappar, Guney Figen, Kucuk Adem, Tonbul Halil Zeki, Yeksan Mehdi, Turk Suleyman
1Division of Nephrology, Department of Internal Medicine, Meram School of Medicine, Konya University, Konya, Turkey; 2Departments of 2Cardiology; and 3Neurology; and 4Division of Rheumatology, Department of Internal Medicine, Meram School of Medicine, Konya University, Konya, Turkey.
Am J Ther. 2014 Nov-Dec;21(6):e189-95. doi: 10.1097/MJT.0b013e31825a364a.
Colchicine has been used in a number of disorders. Because colchicine is partially excreted from the kidney, there is a need for dose reduction in case of renal functional impairment. There are no data with regards to safe dosing schedule of colchicine in hemodialysis patients. We aimed to evaluate adverse effects of colchicine use in a hemodialysis cohort. We screened hemodialysis patients who were using colchicine for any reason. All patients were interviewed regarding possible toxicities of colchicine use and were examined with a special focus on neuromuscular system. Creatine kinase and myoglobin were used to detect any subclinical muscle injury or rhabdomyolysis, respectively. Twenty-two maintenance hemodialysis patients who were on colchicine for more than 6 months and 20 control hemodialysis patients not using colchicine were included in the study. Four of 22 patients were using 0.5 mg/day, 4 patients were using 1.5 mg/day, and 14 patients were using 1 mg/day colchicine. Mean duration for colchicine use was 8.9±8.2 years. There was no difference between the groups in terms of myoneuropathic signs and symptoms and blood counts except for white blood cell count, which was significantly higher in patients on colchicine. Serum creatine kinase (56.3±39.5 and 52.1±36.1 for colchicine and control groups, respectively, P=0.72) and myoglobin (191.4±108.8 and 214.6±83.5 for colchicine and control groups, respectively, P=0.44) levels were not different between the groups. We conclude that in a small number of haemodialysis patients who were apparently tolerating colchicine, detailed assessment revealed no evidence of sublinical toxicity when compared with controls.
秋水仙碱已被用于多种疾病。由于秋水仙碱部分经肾脏排泄，肾功能损害时需要减量。关于血液透析患者秋水仙碱的安全给药方案尚无数据。我们旨在评估血液透析队列中使用秋水仙碱的不良反应。我们筛选了因任何原因使用秋水仙碱的血液透析患者。所有患者均接受了关于使用秋水仙碱可能的毒性的访谈，并对神经肌肉系统进行了特别检查。分别使用肌酸激酶和肌红蛋白检测任何亚临床肌肉损伤或横纹肌溶解。本研究纳入了22例接受维持性血液透析且使用秋水仙碱超过6个月的患者以及20例未使用秋水仙碱的对照血液透析患者。22例患者中，4例每天使用0.5毫克，4例每天使用1.5毫克，14例每天使用1毫克秋水仙碱。秋水仙碱的平均使用时间为8.9±8.2年。除白细胞计数外，两组在肌神经病变体征和症状及血细胞计数方面无差异，使用秋水仙碱的患者白细胞计数显著更高。两组血清肌酸激酶水平（秋水仙碱组和对照组分别为56.3±39.5和52.1±36.1，P = 0.72）和肌红蛋白水平（秋水仙碱组和对照组分别为191.4±108.8和214.6±83.5，P = 0.44）无差异。我们得出结论，在少数明显耐受秋水仙碱的血液透析患者中，与对照组相比，详细评估未发现亚临床毒性的证据。
