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Curr Drug Metab：肾衰竭患者主要通过肝脏清除抗癌药物

2020-03-01 不详 网络

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有证据表明，肾功能不全会影响药物的全身使用，这些药物主要通过肝脏消除。严重肾功能衰竭患者的全身循环中，包括尿毒症毒素在内的各种实体在肝脏和/或小肠中表达的药物代谢酶和转运蛋白的调节是非典型药代动力学的原因，有时会引起不良事件，对于治疗范围狭窄的药物（例如抗癌药）尤其重要。需要建立针对这些患者的抗癌药物剂量策略。研究人员总结了肾功能不全对全身暴露和抗癌药物安全性的影响。还讨论了这些抗癌药的药代动力学

有证据表明，肾功能不全会影响药物的全身使用，这些药物主要通过肝脏消除。严重肾功能衰竭患者的全身循环中，包括尿毒症毒素在内的各种实体在肝脏和/或小肠中表达的药物代谢酶和转运蛋白的调节是非典型药代动力学的原因，有时会引起不良事件，对于治疗范围狭窄的药物（例如抗癌药）尤其重要。需要建立针对这些患者的抗癌药物剂量策略。

研究人员总结了肾功能不全对全身暴露和抗癌药物安全性的影响。还讨论了这些抗癌药的药代动力学改变的拟议机制。

结果，在10种细胞毒性抗癌药物中，有9种报告了药代动力学和临床反应的变化，尽管可用信息有限，有时存在争议。严重肾功能衰竭患者中16种酪氨酸激酶抑制剂中有3种的全身暴露水平高于正常肾功能患者。尽管证据有限，OATP1B1的底物仍可能观察到肾功能不全患者体内抗癌药物的全身暴露增加。

总之，尿毒症对消除非肾脏药物的影响的分子基础仍然需要通过进一步的研究来阐明，以产生可推广的概念，这可能为建立更好的抗癌药物临床应用提供见解，即确定有风险的患者和调整剂量。

原始出处：


Ken-ichi Fujita, Natsumi Matsumoto, et al., Decreased Disposition of Anticancer Drugs Predominantly Eliminated viathe Liver in Patients with Renal Failure. Curr Drug Metab. 2019 Apr; 20(5): 361–376. doi: 10.2174/1389200220666190402143125

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    2021-01-16 一闲

    #MET#

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    2021-01-17 wangbingxhy

    #Drug#

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    2020-12-16 guojianrong

    #Meta#

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    2020-03-03 yang0210

    #肾衰竭#

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1896608, encodeId=89d91896608e8, content=<a href='/topic/show?id=4a391158248' target=_blank style='color:#2F92EE;'>#MET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11582, encryptionId=4a391158248, topicName=MET)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18fc139, createdName=一闲, createdTime=Sat Jan 16 17:22:00 CST 2021, time=2021-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1862341, encodeId=10761862341c5, content=<a href='/topic/show?id=1f0e626267' target=_blank style='color:#2F92EE;'>#Drug#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6262, encryptionId=1f0e626267, topicName=Drug)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=baf586, createdName=wangbingxhy, createdTime=Sun Jan 17 12:22:00 CST 2021, time=2021-01-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1888112, encodeId=b1f71888112a5, content=<a href='/topic/show?id=d56611584ec' target=_blank style='color:#2F92EE;'>#Meta#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11584, encryptionId=d56611584ec, topicName=Meta)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d8f4110, createdName=guojianrong, createdTime=Wed Dec 16 18:22:00 CST 2020, time=2020-12-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1299254, encodeId=2595129925408, content=<a href='/topic/show?id=e7e882e50df' target=_blank style='color:#2F92EE;'>#肾衰竭#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82750, encryptionId=e7e882e50df, topicName=肾衰竭)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ad7f282, createdName=yang0210, createdTime=Tue Mar 03 01:22:00 CST 2020, time=2020-03-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1308270, encodeId=b8e413082e084, content=<a href='/topic/show?id=6e495554550' target=_blank style='color:#2F92EE;'>#抗癌药物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55545, encryptionId=6e495554550, topicName=抗癌药物)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9fe6351, createdName=flyingeagle77, createdTime=Tue Mar 03 01:22:00 CST 2020, time=2020-03-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1314878, encodeId=c20513148e8df, content=<a href='/topic/show?id=9d4b5554131' target=_blank style='color:#2F92EE;'>#抗癌药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55541, encryptionId=9d4b5554131, topicName=抗癌药)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=12de429, createdName=sunylz, createdTime=Tue Mar 03 01:22:00 CST 2020, time=2020-03-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=379964, encodeId=32313e996419, content=嗯, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=02915288922, createdName=ymh8860806_65079110, createdTime=Sun Mar 01 20:39:43 CST 2020, time=2020-03-01, status=1, ipAttribution=)]
    2020-03-03 flyingeagle77

    #抗癌药物#

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1896608, encodeId=89d91896608e8, content=<a href='/topic/show?id=4a391158248' target=_blank style='color:#2F92EE;'>#MET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11582, encryptionId=4a391158248, topicName=MET)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18fc139, createdName=一闲, createdTime=Sat Jan 16 17:22:00 CST 2021, time=2021-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1862341, encodeId=10761862341c5, content=<a href='/topic/show?id=1f0e626267' target=_blank style='color:#2F92EE;'>#Drug#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6262, encryptionId=1f0e626267, topicName=Drug)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=baf586, createdName=wangbingxhy, createdTime=Sun Jan 17 12:22:00 CST 2021, time=2021-01-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1888112, encodeId=b1f71888112a5, content=<a href='/topic/show?id=d56611584ec' target=_blank style='color:#2F92EE;'>#Meta#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11584, encryptionId=d56611584ec, topicName=Meta)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d8f4110, createdName=guojianrong, createdTime=Wed Dec 16 18:22:00 CST 2020, time=2020-12-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1299254, encodeId=2595129925408, content=<a href='/topic/show?id=e7e882e50df' target=_blank style='color:#2F92EE;'>#肾衰竭#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82750, encryptionId=e7e882e50df, topicName=肾衰竭)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ad7f282, createdName=yang0210, createdTime=Tue Mar 03 01:22:00 CST 2020, time=2020-03-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1308270, encodeId=b8e413082e084, content=<a href='/topic/show?id=6e495554550' target=_blank style='color:#2F92EE;'>#抗癌药物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55545, encryptionId=6e495554550, topicName=抗癌药物)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9fe6351, createdName=flyingeagle77, createdTime=Tue Mar 03 01:22:00 CST 2020, time=2020-03-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1314878, encodeId=c20513148e8df, content=<a href='/topic/show?id=9d4b5554131' target=_blank style='color:#2F92EE;'>#抗癌药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55541, encryptionId=9d4b5554131, topicName=抗癌药)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=12de429, createdName=sunylz, createdTime=Tue Mar 03 01:22:00 CST 2020, time=2020-03-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=379964, encodeId=32313e996419, content=嗯, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=02915288922, createdName=ymh8860806_65079110, createdTime=Sun Mar 01 20:39:43 CST 2020, time=2020-03-01, status=1, ipAttribution=)]
    2020-03-03 sunylz

    #抗癌药#

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1896608, encodeId=89d91896608e8, content=<a href='/topic/show?id=4a391158248' target=_blank style='color:#2F92EE;'>#MET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11582, encryptionId=4a391158248, topicName=MET)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18fc139, createdName=一闲, createdTime=Sat Jan 16 17:22:00 CST 2021, time=2021-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1862341, encodeId=10761862341c5, content=<a href='/topic/show?id=1f0e626267' target=_blank style='color:#2F92EE;'>#Drug#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6262, encryptionId=1f0e626267, topicName=Drug)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=baf586, createdName=wangbingxhy, createdTime=Sun Jan 17 12:22:00 CST 2021, time=2021-01-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1888112, encodeId=b1f71888112a5, content=<a href='/topic/show?id=d56611584ec' target=_blank style='color:#2F92EE;'>#Meta#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11584, encryptionId=d56611584ec, topicName=Meta)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d8f4110, createdName=guojianrong, createdTime=Wed Dec 16 18:22:00 CST 2020, time=2020-12-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1299254, encodeId=2595129925408, content=<a href='/topic/show?id=e7e882e50df' target=_blank style='color:#2F92EE;'>#肾衰竭#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82750, encryptionId=e7e882e50df, topicName=肾衰竭)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ad7f282, createdName=yang0210, createdTime=Tue Mar 03 01:22:00 CST 2020, time=2020-03-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1308270, encodeId=b8e413082e084, content=<a href='/topic/show?id=6e495554550' target=_blank style='color:#2F92EE;'>#抗癌药物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55545, encryptionId=6e495554550, topicName=抗癌药物)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9fe6351, createdName=flyingeagle77, createdTime=Tue Mar 03 01:22:00 CST 2020, time=2020-03-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1314878, encodeId=c20513148e8df, content=<a href='/topic/show?id=9d4b5554131' target=_blank style='color:#2F92EE;'>#抗癌药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55541, encryptionId=9d4b5554131, topicName=抗癌药)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=12de429, createdName=sunylz, createdTime=Tue Mar 03 01:22:00 CST 2020, time=2020-03-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=379964, encodeId=32313e996419, content=嗯, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=02915288922, createdName=ymh8860806_65079110, createdTime=Sun Mar 01 20:39:43 CST 2020, time=2020-03-01, status=1, ipAttribution=)]
    2020-03-01 ymh8860806_65079110

    嗯

    0