Pharmacodynamic study of low molecular weight dermatan sulphate (Desmin) after a single subcutaneous administration in patients with renal insufficiency
S. Saivin et al., Pharmacodynamic study of low molecular weight dermatan sulphate (Desmin) after a single subcutaneous administration in patients with renal insufficiency, ARZNEI-FOR, 50(9), 2000, pp. 821-826
The pharmacodynamic pattern of low molecular weight dermatan sulphate (CAS
24967-94-0, Desmin-LMWDS) was studied in patients presenting chronic renal
insufficiency. Three groups of six patients were defined according to their
creatinine clearance: group 1, more than 50 ml/ min, group 2 between 10 an
d 50 ml/min and group 3 lower than 10 ml/min (haemodialized patients). Desm
in-LMWDS concentrations were determined with the Heptest assay and the chro
mogenic specific heparin cofactor II dependent anti IIa assay. In patients
of group 1 affected by moderate renal insufficiency, the pharmacodynamic pr
ofiles were roughly comparable to those obtained in normal subjects. In the
two other groups, the profiles were markedly modified by the renal insuffi
ciency. The maximal concentrations were doubled and the areas under the tim
e-activity curve were 4-fold higher in haemodialyzed (group 3) and severe r
enal insufficient patients (group 2) than in patients of group 1. The clear
ance of the anti IIa activity were 13.98 +/- 6.25 l/h; 4.12 +/- 2.64 l/h an
d 2.94 +/- 1,53 l/h and the half-lives were 2.79 +/- 2.60 h, 6.15 +/- 4.02
h and 11.51 +/- 6.54 h in groups 1 to 3, respectively (p < 0.05). The Desmi
n-LMWDS clearance was directly correlated to the creatinine clearance (r =
0.8244, n = 18, p < 0.001). Thus, as for low molecular weight heparin, rena
l function plays a major role in the elimination of low molecular weight de
rmatan sulphate.