nidНефрология и диализNephrology and Dialysis1680-44222618-9801Российское диализное обществоnid-1965Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESФармакокинетика рекомбинантного человеческого эритропоэтина (рчЭРП) при внутривенном, подкожном и внутрибрюшном введении у больных на перитонеальном диализе (ПД)Pharmacokinetics of intravenous, subcutaneous and intraperitoneal recombinant human erythropoietin in patients on peritoneal dialysisЕрмоленкоВ. М.ErmolenkoV. M.noemail@neicon.ruМаргиеваО. Б.MargievaO. B.noemail@neicon.ruШутовЕ. В.ShutovE. V.noemail@neicon.ruУсубаливаА. .UsubalievaA. .noemail@neicon.ruРоссийская медицинская академия последипломного образования, кафедра нефрологии и гемодиализа, МоскваRussian Federation20042706202563235238Copyright © Ермоленко В.М., Маргиева О.Б., Шутов Е.В., Усубалива А..., 20252025Ермоленко В.М., Маргиева О.Б., Шутов Е.В., Усубалива А...Ermolenko V.M., Margieva O.B., Shutov E.V., Usubalieva A...Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.nephro.ru/jour/article/view/1965

Изучали фармакокинетику рчЭРП, вводимого в дозе 100 Ед/кг интраперитонеально, подкожно и внутривенно 30 стабильным больным, получающим перитонеальный диализ. Внутрибрюшинно рчЭРП вводили в 3 режимах: вместе с диализирующим раствором в объеме 2 л, в осушенную брюшную полость (время экспозиции 8 и 14 часов). Концентрацию ЭРП в образцах сыворотки и диализата определяли с помощью двухкомпонентного твердофазового иммуноферментного анализа. Пробы крови отбирали в течение 48 часов, а перитонеальный эффлюент - при первом сливе. Площадь под фармакологической кривой и биодоступность рчЭРП при внутрибрюшинном введении была выше при экспозиции препарата в осушенной брюшной полости (8 и 14 часов), чем при подкожном введении. Максимальная концентрация ЭПО была достигнута при внутривенном введении и оказалась заметно ниже при внутрибрюшном и подкожном. Период полуэлиминаци был наименьшим при внутривенном введении препарата, а при введении внутрибрюшинно в осушенную брюшную полость и подкожно был сравним. Количество ЭПО, удаляемого с перитонеальным с эффлюентом, зависело от времени экспозиции препарата в брюшной полости. Таким образом, фармакокинетические параметры, полученные у больных при введении рчЭРП в пустую брюшную полость с длительной экспозицией, позволяют рекомендовать этот путь для применения в клинической практике.

The pharmacokinetics of recombinant human erythropoietin (Epo) was compared after single dose 100 U/kg intraperitoneal (IP), subcutaneous (SC) and intravenous (IV) administration in 30 noninfected patients on peritoneal dialysis. IP mode was used in 3 regimens: together with 2 liters of dialysate and into dried peritoneum with normal saline 50 ml (dwell time dry was 8 and 14 hours). Blood samples were collected during 48 hours, effluent dialysate from the first postdose exchange was selected to determine Epo recovery. Enzyme immunoassay was used for Epo analysis. Standard pharmacokinetics methods were employed for analysis of the serum Epo concentration. The area under the dosing-requirement curve for IP EPO into a dry peritoneum and bioavailability was larger than for SC administration (p<0,05). IP administration results the higher peak concentration in patients using a 14-hour dry dwell than in patients receiving EPO together with 2 liters and after SC dose, but lower than IV route. After IV administration EPO plasma concentrations half-life was least. The absorption of Epo administered by the IP route improves by extending the time of exposition in peritoneum (% dose recovered in first post-dose dialysate corresponded 76, 25,6 and 11,2 accordingly). In conclusion, the pharmacokinetics of Epo in a dry peritoneum suggests that this route may have potential clinical benefit.

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The authors declare that there are no conflicts of interest present.