CORRELATIONS BETWEEN THE STAGES OF KIDNEY DISEASE AND
THE PHARMACOKINETIC PARAMETERS OF ORALLY ADMINISTERED
CIPROFLOXACIN AT PATIENTS WITH CHRONIC KIDNEY DISEASE

MIHAI CIPRIAN STOICA1, CAMIL EUGEN VARI2*, SILVIA IMRE3, SZENDE VANCEA3, MARIA TITICA DOGARU2, EMILIAN CARAŞCA4, IONUŢ DORIN TARŢA1, GRIGORE DOGARU1, CARMEN DENISE CĂLDĂRARU5
University of Medicine and Pharmacy, 38 Gheorghe Marinescu street, RO-540139, Târgu-Mureş, România
1Department of Nephrology
2Department of Pharmacology
3Department of Analytical Chemistry and Drug Analysis
4Department of Internal Medicine IV
5Department of Physiology
*corresponding author: camil.vari@yahoo.fr
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Abstract:
Patients with chronic kidney disease (CKD) are a special population group, which often present associated infections,
requiring antimicrobian therapy. The study concerned the surveillance of pharmacotherapy of ciprofloxacin administered in
patients diagnosed with CKD and associated infections, to increase the efficiency of therapy and to avoid toxicity of the drug
substance. The prospective, open pharmacokinetic study, was conducted over a 15 months interval and was carried out on 29
patients diagnosed with CKD for which the plasmatic and urinary concentration of ciprofloxacin was determined using a
validated high-performance liquid chromatography method (HPLC), following the oral administration of the drug. The
efficiency of ciprofloxacin therapy was assessed according to the clinical, para-clinical, pharmacokinetic and toxic criteria.
The most significant proportion of side effects was recorded in patients with CKD stage 3 (n = 10). We have discovered
correlations between ciprofloxacin individual half-life and estimated glomerular filtration rate (eGFR) (p = 0.022), as well as
the percentage of the urinary cleared drug in 24 hours and the level of serum creatinine (p = 0.024). Furthermore, it was
recorded that the values of lactate dehydrogenase (LDH) (p = 0.033) and total cholesterol (p = 0.001) were lower after
ciprofloxacin therapy. In order to enhance the efficacy of ciprofloxacin in CKD patients, a dose decrease is required and not a
shortening of the interval of administration, even at patients in the early stages of illness, to avoid side effects. Using the
assessment of individual pharmacokinetic values of the studied patients, the study group can be extended, and a research
based on populational pharmacokinetics could be initiated in the future.






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