PHARMACOKINETICS OF CARBOPLATIN IN A PATIENT WITH CERVICAL-CANCER WITH URETERAL OBSTRUCTION BEFORE, DURING, AND AFTER HEMODIALYSIS

The pharmacokinetics of total and free (ultrafilterable) platinum were investigated in a patient with cervical cancer with ureteric obstruct ion who, at the time of carboplatin administration, appeared to have a mild renal impairment (i.e., creatinine clearance 1 mL/s), but develo ped an acute renal failure shortly thereafter, which required hemodial ysis. The decline in the concentration of total or free Pt in plasma a s function of time correlated well (P < 0.0098) with that of serum cre atinine concentration. The elimination half-lives (t1/2) of total and free Pt in this patient were eight- and nine-fold longer than those ob served earlier for patients with normal renal function, and the total body clearance was 12.4% and 18.4%, respectively. Although t1/2 of Pt during dialysis was two to three times (total Pt) and eight times (fre e Pt) shorter than those observed before and after dialysis, three ses sions of hemodialysis removed only 5.6% of total Pt and 9.3% of free P t. Because the pre- and post-dialysis t1/2 values were similar, hemodi alysis apparently had no impact on the intrinsic elimination of Pt in this patient.