Abstract
The interrelationships between electrolyte and uric acid metabolism, renal function and HCT pharmacokinetics have been studied to determine whether modifications in current dosing practices would be beneficial in HT or RI children.
Outpatients (OP) on chronic HCT therapy received one-half their daily dose (0.6-2.75 mg/kg) in the morning and steady state HCT, Na, K, creatinine, BUN and uric acid levels determined. In-patients (IP) received a single HCT dose on a fixed protocol. Blood specimens were obtained at 0,1,2,4,8,12 and 24 hours and urine specimens at 0-2,2-4,4-8,8-12 and 12-24 hours. HCT was assayed by high pressure liquid chromatography.
Serum HCT levels varied directly with dosage and inversely with Ccr. When Ccr exceeded 70 ml/min, OP receiving 1-1.5 mg/kg had HCT levels ranging from 130-190 μg/ml whereas levels between 260-600 μg/ml were found with doses of 2.0-2.75 mg/kg. When Ccr was below 50 ml/min extraordinarily high HCT levels (1000-4000 μg/ml) were observed even with doses less than 1.0 mg/ml. Serum half-life and elimination rates were inversely proportional to renal clearance in IP.
These data suggest that HCT accumulates in RI patients if no dosage adjustment is made. No positive correlation was established between elevated serum HCT levels and adverse reactions. (Supported by USPHS Grant HD-08580.)
Article PDF
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Mirkin, B., Sinaiko, A., Cooper, M. et al. HYDROCHLOROTHIAZIDE (HCT) THERAPY IN HYPERTENSIVE (HT) AND RENAL INSUFFICIENT (RI) CHILDREN: ELIMINATION KINETICS AND METABOLIC EFFECTS. Pediatr Res 11, 418 (1977). https://doi.org/10.1203/00006450-197704000-00295
Issue Date:
DOI: https://doi.org/10.1203/00006450-197704000-00295
This article is cited by
-
Disposition and pharmacodynamics of diuretics and antihypertensive agents in renal disease
European Journal of Clinical Pharmacology (1980)