From the Research
Propofol Removability by Dialysis
- The removability of propofol by dialysis is a topic of interest in patients with renal failure.
- A study published in 1996 1 investigated the serum protein binding of propofol in patients with renal failure and found that chronic renal failure did not significantly modify serum protein binding of propofol.
- The study also found that patients in periodic dialysis did not show changes in propofol binding either compared before or after hemodialysis.
- Another study published in 1998 2 investigated the pharmacokinetics and pharmacodynamics of propofol in patients with end-stage renal disease and found that the pharmacokinetic and pharmacodynamic profiles of propofol after infusion were not markedly affected by renal failure.
- However, a case report published in 2016 3 described a patient with end-stage renal disease who developed propofol-induced hyperkalemia, which was successfully treated with hemodialysis.
- This suggests that dialysis may be effective in removing propofol or its metabolites from the body in certain cases.
Pharmacokinetics of Propofol
- The pharmacokinetics of propofol have been studied in various populations, including patients with renal failure.
- A study published in 2008 4 investigated the recovery and long-term renal excretion of propofol and its metabolites after propofol infusion during surgery.
- The study found that propofol and its metabolites were still detectable in the urine after 60 hours, suggesting that the kidney plays a role in the elimination of propofol.
- Another study published in 2008 5 investigated the pharmacokinetics and pharmacodynamics of a water-soluble propofol prodrug, GPI 15715 or fospropofol, and found that it was well suited to provide anaesthesia or conscious sedation.
Clinical Implications
- The studies suggest that propofol is not significantly removed by dialysis in patients with renal failure.
- However, dialysis may be effective in removing propofol or its metabolites from the body in certain cases, such as in patients with propofol-induced hyperkalemia.
- The pharmacokinetic and pharmacodynamic profiles of propofol are not markedly affected by renal failure, but the drug should be used with caution in patients with renal impairment.