Roux A F, Moirot E, Delhotal B, Leroy J A, Bonmarchand G P, Humbert G, Flouvat B
Clin Pharmacol Ther. 1984 Sep;36(3):363-8. doi: 10.1038/clpt.1984.188.
Nine patients with acute renal failure who were undergoing dialysis at intervals depending on clinical state were injected with metronidazole, 7.5 mg . kg-1 iv every 8 hr. Plasma samples were drawn during the 8 hr after the first infusion, during the first dialysis session, and during the course of the fourth infusion after the first three dialysis sessions. Metronidazole and its two main metabolites (alcohol [M1] and acid [M2]) were assayed by HPLC. The plasma t 1/2 of metronidazole (6.8 hr) is of the same order as that in healthy subjects. M1 and M2 plasma levels increased continuously until the next infusion. Dialysis clearances of metronidazole and its metabolites were about 60 ml . min-1; 25% of metronidazole in the body at the beginning of hemodialysis was eliminated. The corresponding apparent t 1/2 s are 3.3 hr (metronidazole), 8.0 hr (M1), and 7.9 hr (M2). In patients with acute renal disease under hemodialysis, there was no cumulation of metronidazole and its metabolites; hence there is no need for change in dosage regimen.
9例急性肾衰竭患者根据临床状况定期进行透析，每8小时静脉注射7.5mg/kg甲硝唑。在首次输注后的8小时内、首次透析期间以及在前三次透析后的第四次输注过程中采集血样。采用高效液相色谱法测定甲硝唑及其两种主要代谢产物（醇类[M1]和酸类[M2]）。甲硝唑的血浆半衰期（6.8小时）与健康受试者的相近。M1和M2的血浆水平持续升高直至下一次输注。甲硝唑及其代谢产物的透析清除率约为60ml·min-1；血液透析开始时体内25%的甲硝唑被清除。相应的表观半衰期分别为3.3小时（甲硝唑）、8.0小时（M1）和7.9小时（M2）。在接受血液透析的急性肾病患者中，甲硝唑及其代谢产物无蓄积；因此无需改变给药方案。
