Urodynamic model was developed which, in conjunction with a compartmental pharmacokinetic model, was used for study of factors influencing drug concentrations in urine: urine flow rate, residual ...bladder urine, maximal bladder urine, stage of renal failure, and elimination kinetics of drugs. Norfloxacin (NOR) was used as a model drug, although the model haw general applicability for all urinary antiseptics. Pharmacokinetic data were obtained from a clinical study in which norfloxacin was administered orally as a single 400mg dose to four subjects with installed urine catheters. Sample of blood, bladder and catheter urine were collected and concentrations of NOR measured by a HPCL method. Modeling was performed on analog--hybrid computer EAI 580. Besides the fitting of model response to obtained in vivo data, simulations of expected clinical situations were performed in which the interplay of above mentioned factors was studied in terms of urine concentrations profiles. NOR treatment with 400mg b.i.d. secured sufficient urine concentrations in most studied cases. This approach should be applied for corresponding study of other urinary antiseptics, especially those with less favourable urinary levels.
Renal transplantation has become an acceptable mode of therapy for patients with end-stage renal failure since the early 1960s. Retrospective study was done to analyze clinical results od 126 ...patients who received either living related or cadaveric kidney. The cumulative graft survival rate was 90% one year and 80% four years after living related kidney transplantation. The corresponding patient survival rate was 96% one year and 94% four years after transplantation. There were no significant differences in graft and patient survival regarding mode of immunosuppressive therapy. In cadaveric kidney transplantation graft survival after one year was 78% and patient survival ranged at 98%. Our results are comparable to those of other centers and we think renal transplantation is adequate therapy for most patients with end-stage renal disease.
