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Pharmacokinetics of nicotine in kidney failure
Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Pharmacology.
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2000 (English)In: Clinical Pharmacology and Therapeutics, ISSN 0009-9236, Vol. 68, no 3, 250-260 p.Article in journal (Refereed) Published
Abstract [en]

Background: Smoking is an important risk factor for cardiovascular and cerebrovascular complications in patients with chronic kidney failure. Very high plasma nicotine concentrations have been reported in patients with severe kidney failure, indicating that the disposition of nicotine in these patients may be different. The purpose of this study was to assess the pharmacokinetics of intravenously administered nicotine in healthy subjects and in patients with kidney failure. Methods: Nine healthy subjects (glomerular filtration rare [GFR], 84 to 143 mL/min/1.73 m2), four patients with mild kidney failure (GFR, 63 to 73 mL/min/1.73 m2), five patients with moderate kidney failure (GFR, 18 to 36 mL/min/1.73 m2), and six patients with severe kidney failure (GFR, 1 to 10 mL/min/1.73 m2) were recruited. Three patients were treated with continuous ambulatory peritoneal dialysis. An intravenous infusion of nicotine (0.028 mg/kg) was given for 10 minutes. Nicotine and cotinine concentrations were measured in plasma, urine, and peritoneal dialysate from 0 to 24 hours after start of infusion Results: There were significant correlations between GFR and total clearance, nonrenal and renal clearance of nicotine, area under the plasma concentration-time curve extrapolated to infinity, terminal elevation half-life, and mean residence time. Nonrenal clearance was 1303 mL/min and 661 mL/min in healthy subjects and patients with severe kidney failure, respectively. Only 1% to 2% of the nicotine dose was excreted unchanged in a 24-hour collection of peritoneal dialysate. The elimination of cotinine was also decreased in patients with kidney failure. Conclusion: Progressive kidney failure is associated with a gradual decrease of renal and nonrenal elimination of nicotine.

Place, publisher, year, edition, pages
2000. Vol. 68, no 3, 250-260 p.
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-26938DOI: 10.1067/mcp.2000.109006Local ID: 11565OAI: diva2:247488
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2011-01-14

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Hoffman, Mikael
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Faculty of Health SciencesClinical PharmacologyDepartment of Clinical PharmacologyInternal MedicineDepartment of Nephrology UHL
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