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评估长期持续使用美沙酮对接受口服美沙酮(糖浆剂)患者肾小球滤过率的影响。

Evaluating the effect of chronic and continuous use of methadone on the glomerular filtration rate of patients receiving oral methadone (syrup).

作者信息

Chegini Valiollah Goudarzvand, Kazemifar Amir Mohammad, Tavakolian Amir Ershad, Karimi Arian Ghannadi, Sofi Arsalan Jamali Pour, Ipchian Darya, Kamali Sahand, Varkiani Mehran Ebrahimi, Yazdi Zohreh

机构信息

Department of Nephrology, Velayat Hospital, Qazvin University of Medical Sciences, Qazvin, Qazvin, Iran.

Professor of Clinical Toxicology and Forensic Medicine, Qazvin University of Medical Sciences, Qazvin, Qazvin, Iran.

出版信息

Front Med (Lausanne). 2024 Dec 19;11:1496505. doi: 10.3389/fmed.2024.1496505. eCollection 2024.

Abstract

INTRODUCTION

This study systematically examines the effects of chronic oral methadone use on the glomerular filtration rate (GFR) in patients participating in methadone maintenance therapy (MMT) in Qazvin City, Iran. Methadone, a synthetic -opioid receptor agonist, is predominantly utilized for the management of opioid dependence and pain relief; however, there is growing concern regarding its potential nephrotoxic effects.

METHODS

An observational cross-sectional study was executed involving 150 participants who had been on methadone syrup for a minimum duration of 2 years. Comprehensive data pertaining to demographic variables, methadone dosage, and serum creatinine levels were meticulously gathered at baseline, as well as at 3 and 6 months. GFR was calculated utilizing the Cockcroft-Gault formula.

RESULTS

The results demonstrate that, while the mean GFR values remained within the normal range, a significant correlation was observed between methadone dosage and a reduction in GFR; specifically, higher dosages were associated with lower GFR values. In contrast, the duration of methadone use did not significantly affect GFR.

CONCLUSION

These findings indicate that, although methadone dosage may influence renal function, long-term methadone therapy does not inherently exacerbate the risk of chronic kidney disease (CKD) in this population. This underscores the critical need for diligent monitoring of methadone dosages to mitigate the risk of potential renal impairment and highlights the importance of further research into the long-term implications of methadone on renal health.

摘要

引言

本研究系统地考察了伊朗加兹温市接受美沙酮维持治疗(MMT)的患者长期口服美沙酮对肾小球滤过率(GFR)的影响。美沙酮是一种合成的阿片受体激动剂,主要用于治疗阿片类药物依赖和缓解疼痛;然而,人们对其潜在的肾毒性作用日益担忧。

方法

开展了一项观察性横断面研究,纳入150名服用美沙酮糖浆至少2年的参与者。在基线以及3个月和6个月时,精心收集了有关人口统计学变量、美沙酮剂量和血清肌酐水平的综合数据。使用Cockcroft-Gault公式计算GFR。

结果

结果表明,虽然平均GFR值仍在正常范围内,但观察到美沙酮剂量与GFR降低之间存在显著相关性;具体而言,剂量越高,GFR值越低。相比之下,美沙酮使用时间对GFR没有显著影响。

结论

这些发现表明,虽然美沙酮剂量可能影响肾功能,但长期美沙酮治疗本身并不会增加该人群患慢性肾脏病(CKD)的风险。这突出了严格监测美沙酮剂量以降低潜在肾功能损害风险的迫切需要,并强调了进一步研究美沙酮对肾脏健康长期影响的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/782c/11693653/1df224c403af/fmed-11-1496505-g001.jpg

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