Removal of Methotrexate by Peritoneal Dialysis and Hemodialysis in a Single Patient with End-Stage Renal Disease

@article{Diskin2006RemovalOM,
  title={Removal of Methotrexate by Peritoneal Dialysis and Hemodialysis in a Single Patient with End-Stage Renal Disease},
  author={Charles J. Diskin and Thomas J. Stokes and Linda M. Dansby and Lautrec Radcliff and Thomas B. Carter},
  journal={The American Journal of the Medical Sciences},
  year={2006},
  volume={332},
  pages={156-158}
}
Background:Although methotrexate is highly bound to albumin, it is thought to be removed by hemodialysis and not by peritoneal dialysis. We are not aware of any direct comparison in the same patient. Case Report/Methods:A 60-year-old patient on continuous ambulatory peritoneal dialysis was admitted to the East Alabama Medical Center for stomatitis and pancytopenia after being given 10 mg of methotrexate for his rheumatoid arthritis. Measurements of total methotrexate levels were made before… Expand
Methotrexate clearance by high-flux hemodialysis and peritoneal dialysis: a case report.
TLDR
Despite lower clearance by means of peritoneal dialysis compared with hemodialysis, the patient did not develop clinical evidence of methotrexate toxicity. Expand
Successful multiple-exchange peritoneal dialysis in a patient with severe hematological toxicity by methotrexate: case report and literature review
TLDR
A 68-year-old man with chronic, end-stage renal disease associated with ANCA vasculitis is presented, who received the medication at a low dose, indicated by disease activity, which presented as a complication with severe pancytopenia with mucositis that improved with support measures and multiple-exchange peritoneal dialysis. Expand
Pancytopenia After Low-Dose Methotrexate Therapy in Two Hemodialysis Patients with Rheumatoid Arthritis.
  • Tao Pu, Yu Ni, Pan-Hong Li, Dan Yu, Qiong Yu, Li-Mei Yu
  • Medicine
  • The American journal of the medical sciences
  • 2021
TLDR
Two hemodialysis patients with RA who presented with a complication of severe pancytopenia after treatment with MTX are presented and high morbidity and mortality were observed, indicating that MTX should be used cautiously in the absence of alternatives. Expand
Clinical dilemma over low-dose methotrexate therapy in dialysis patients: a case report and review of literature.
TLDR
It is highlighted that methotrexate therapy in dialysis patients, even with low doses could impose the risk of myelosuppression, causing a fatal outcome. Expand
High dose methotrexate and extended hours high-flux hemodialysis for the treatment of primary central nervous system lymphoma in a patient with end stage renal disease.
TLDR
The case of a 52 year old female with post-transplant lymphoproliferative disorder, confined to the central nervous system, which was managed with high dose methotrexate (HDMTX) in the context of end stage renal disease, shows Dialysis-dependent renal failure does not preclude the use of HDMTX when required for curative therapy of malignancy. Expand
Leflunomide in dialysis patients with rheumatoid arthritis—a pharmacokinetic study
Pharmacokinetic data of disease modifying antirheumatic drugs during hemodialysis are limited to sulfasalazine, methotrexate, and cyclosporine. Only respective anecdotal data have been reported onExpand
Brief Communication High dose methotrexate and extended hours high-flux hemodialysis for the treatment of primary central nervous system lymphoma in a patient with end stage renal disease
This report discusses the case of a 52 year old female with post-transplant lymphoproliferative disorder, confined to the central nervous system, which was managed with high dose methotrexate (HDMTX)Expand
Fatal Pancytopenia in a Hemodialysis Patient After Treatment With Low-Dose Methotrexate
TLDR
It is reported that a 56-year-old male hemodialysis patient who developed fatal pancytopenia after treatment with low-dose methotrexate for psoriasis and psoriatic arthropathy should not be used to treat rheumatic conditions in dialysis patients. Expand
Combined acute interstitial pneumonitis and pancytopenia induced by low-dose methotrexate in a hemodialysis patient treated for bullous pemphigoid*
TLDR
A 48-year-old man with end-stage renal disease undergoing chronic hemodialysis developed combined acute pneumonitis and pancytopenia after a cumulative dose of 20 mg methotrexate for bullous pemphigoid after continuous renal replacement therapy (CRRT). Expand
Anti-neoplastic agents for patients on peritoneal dialysis: A systematic review.
TLDR
The aim of this study was to systematically review current evidence on the use of systemic oncology therapies in peritoneal dialysis and suggest the need for dose adjustment of each drug. Expand
...
1
2
3
...

References

SHOWING 1-10 OF 13 REFERENCES
Effective clearance of methotrexate using high-flux hemodialysis membranes.
TLDR
It is concluded that significant clearance of methotrexate can be achieved with high-flux dialyzers, making methotRexate therapy a viable treatment option in patients with responsive malignancies despite the presence of renal failure. Expand
Methotrexate-induced renal failure and ineffectiveness of peritoneal dialysis.
TLDR
Renal histological studies showed severe tubulointerstitial damage consistent with MTX toxicity, and better alternatives for removing MTX in patients with renal failure are clearly needed. Expand
Methotrexate removal during haemodialysis in a patient with advanced laryngeal carcinoma
TLDR
The rate of MTX elimination was increased during haemodialysis, although high MTX concentrations persisted for several days and prolonged rescue with folinic acid was required, although low-dose MTX was given to a patient on regular haemmodialysis without evidence of toxicity. Expand
A high peritoneal large pore fluid flux causes hypoalbuminaemia and is a risk factor for death in peritoneal dialysis patients.
  • J. Heaf, S. Sarac, S. Afzal
  • Medicine
  • Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
  • 2005
TLDR
Jv(L) is related to hypoalbuminaemia and mortality after PD initiation, and it is suggested that peritoneal albumin loss can have an identical pathogenic effect as urinary albumin losses, by causing an iatrogenic "nephrotic" syndrome. Expand
[Effectiveness of hemodialysis in a case of acute methotrexate poisoning].
TLDR
A kinetic study of plasma methotrexate concentrations enabled the authors to begin treatment with high-permeability membrane haemodialysis combined with intensive folic acid loading before the clinical signs of iatrogenic toxicities developed, and to continue with haemmodialysis rather than using other depurative methods. Expand
The safety and efficacy of the use of methotrexate in long-term therapy for rheumatoid arthritis.
TLDR
Toxicity was noted at some time in 26 of 29 patients (90%), but reactions universally became mild and tolerable after adjustment of the dosage, and there was a significant reduction in mean prednisone dosage. Expand
Protein binding of methotrexate to human albumin and serum. A first derivative spectroscopic analysis.
TLDR
The first derivative spectroscopic analysis was used to estimate the bound and free fractions of methotrexate in human serum and serum albumin (HSA), and scatchard analysis showed one family of binding sites characterized by 2 binding sites and an affinity constant close to that previously calculated using equilibrium dialysis. Expand
High‐dose methotrexate‐induced nephrotoxicity in patients with osteosarcoma
TLDR
The objectives of the current study were to estimate the current incidence of HDMTX‐induced renal dysfunction in patients with osteosarcoma and to compare the efficacy and recovery of renal function for dialysis‐based methods of MTX removal with treatment using CPDG2. Expand
A high peritoneal large pore fluid flux causes hypoalbuminaemia and is a risk factor for death in PD patients
  • Nephrol Dial Transplant
  • 2005
Severe methotrexate intoxication in a haemodialysis patient treated for rheumatoid arthritis.
...
1
2
...