Leuprorelin acetate blood levels and dialysance after the administration of sustained-release leuprorelin acetate in a dialysis case complicated by prostate cancer

Abstract

BACKGROUND The objective of this study is to determine whether in a dialysis patient with prostate cancer leuprorelin acetate blood levels were abnormally high or low due to kidney failure or because of dialysis. METHODS Sustained‐release leuprorelin acetate 3.75 mg was given every 4 weeks for prostate cancer in a 79‐year‐old dialysis patient. Changes in serum level of leuprorelin acetate in this patient were measured before and after dialysis. RESULTS Leuprorelin acetate appeared to have a dialysance close to that of vitamin B12, which has a similar molecular weight. The amount dialyzed did not exceed 8.3% of the amount released per day. Mean blood levels of leuprorelin acetate, as measured in this patient, were higher (0.64 to 1.31 ng/ml) than those in prostate cancer patients with normal kidney function (mean ± SD, 0.24 ± 0.12 to 0.50 ± 0.32 ng/ml). CONCLUSIONS Sustained‐release leuprorelin acetate can be used safely in dialysis patients with prostate cancer. Prostate 34:191–194, 1998. © 1998 Wiley‐Liss, Inc.

Protocols for the Use of Cyproterone, Medroxyprogesterone, and Leuprolide in the Treatment of Paraphilia

“…Since renal impairment may occur with long-term treatment, these levels should be assessed every 6 months during treatment. If renal injury is not a possibility, as in the case ofa patient on dialysis, leuprolide may be used without concern (21).…”

Systemic anticancer therapy in gynecological cancer patients with renal dysfunction

“…Although the serum leuprorelin level in this patient (0.64-1.31 ng/mL) was higher than those in patients with normal renal function (mean AE SDL: 0.24 AE 0.12 to 0.50 AE 0.32 ng/mL), no adverse reactions were noted. The amount of drug removal by hemodialysis did not exceed 8.3% of the amount released per day (145) . Another case report also showed that leuprorelin can be safely used in patients on chronic hemodialysis at the same dose schedule (146) .…”

“…In one case report, a patient with renal failure on chronic hemodialysis received leuprorelin at a dose of 3.73 mg subcutaneously every 4 weeks for the treatment of prostate cancer (145) . Although the serum leuprorelin level in this patient (0.64-1.31 ng/mL) was higher than those in patients with normal renal function (mean AE SDL: 0.24 AE 0.12 to 0.50 AE 0.32 ng/mL), no adverse reactions were noted.…”

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“…Our patient actually responded well to CAB therapy. According to the literature, CAB therapy was effective even in hemodialysis patients and some reported the safe use of LHRH analogues in dialysis patients 10–12 . However, metabolism and the optimal dose of LHRH analogue and flutamide in hemodialysis patients have not yet been defined.…”