The effect of acute and chronic renal failure on theophylline clearance.

Theophylline total body clearance was measured in 29 anuric, chronic obstructive pulmonary disease patients with acute or chronic renal failure during a continuous intravenous infusion. They were divided into two groups depending on the absence (group 1, N = 16) or presence (group 2, N = 13) of congestive heart failure and compared to normal renal function control patients with similar disease states. All study and control patients smoked cigarettes. The theophylline mean total body clearance values (+/- S.D.) for group 1 were 68.0 +/- 14.5, 64.5 +/- 12.9, and 62.6 +/- 17.3 ml/kg.hr for acute renal failure patients, uremic chronic renal failure patients, and control patients, respectively. For group 2, the corresponding values were 25.6 +/- 5.1, 28.6 +/- 8.7, and 27.4 +/- 12.9 ml/kg.hr. There was no significant difference between study and control patients in either group 1 or group 2 (P greater than 0.05, one-way analysis of variance). Since total body clearance determines the steady-state concentration of a drug after repeated administration, theophylline doses do not need to be reduced in acute renal failure or uremia patients.