血液透析患者におけるアニオン性尿毒症物質の血漿中濃度とプラバスタチンのタンパク結合に対する影響

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  • Plasma Concentrations of Anionic Uremic Toxins in Hemodialysis Patients and Their Effects on Protein Binding of Pravastatin
  • ケツエキ トウセキ カンジャ ニ オケル アニオンセイ ニョウドクショウ ブッシツ ノ ケッショウ チュウ ノウド ト プラバスタチン ノ タンパク ケツゴウ ニ タイスル エイキョウ

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  Uremic toxins (UTs) accumulate in the body of hemodialysis patients. UTs often exert unfavorable effects on patients and cause significant interactions with clinically relevant drugs. In this study, we assayed plasma concentrations of three typical anionic UTs, indoxyl sulfate (IS), 3-indoleacetic acid (IA), and 3-carboxy-4-methyl-5-propyl-2-furanpropionic acid (CMPF), in 20 hemodialysis patients and 5 healthy volunteers. Moreover, the effects of these anionic UTs on the binding of pravastatin to human serum albumin (HSA) were also evaluated. CMPF concentrations in the plasma of patients were unchanged before and after dialysis (63.0±6.3 μM and 65.1±6.7 μM, respectively), and these values were about 5-fold greater compared with those in healthy volunteers. Although dialysis decreased the plasma IS concentration from 157.9±19.9 μM to 103.8±13.3 μM, the value after hemodialysis was still ca. 27-fold greater than that in healthy volunteers. IA concentrations before and after hemodialysis were almost identical to those in healthy volunteers. There were no significant differences in the plasma concentrations of the three anionic UTs between male and female patients. The magnitude of protein binding was in the order CMPF>IS>IA, indicating that hemodialysis clearance of these anionic UTs was dependent on their protein binding capacities. The ability of IS to reduce pravastatin binding to HSA was much greater than that of CMPF. The present results suggest that statins bind to site II on HSA, and that their binding is modulated by IS when elevated in hemodialysis patients.<br>

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  • 薬学雑誌

    薬学雑誌 135 (6), 821-828, 2015

    公益社団法人 日本薬学会

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