Pharmacokinetics of atenolol in patients with terminal renal failure and influence of haemodialysis.

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Abstract
1 The pharmacokinetics of atenolol, after 200 mg orally, were studied in 18 patients with terminal renal insufficiency (creatinine clearance less than 5 ml/min), of whom twelve were being treated by chronic dialysis. 2 The peak plasma level, 1.59 +/‐ 0.43 mg/l, was reached in 4.7 +/‐ 2.1 h. 3 Without dialysis treatment, the apparent plasma half‐ life of atenolol was greatly increased (73.4 +/‐ 28.8 /). During dialysis, it dropped to 7.5 +/‐ 3.7 h but returned to 51.2 +/‐ 17.3 h after dialysis. The plasma atenolol plot was a rising slope for a few hours after the end of dialysis. 4 Renal clearance of atenolol was very low (4.6 +/‐ 1.5 ml/min). 5 Plasma clearance during dialysis was 42.6 +/‐ 21.3 ml/min for a mean blood flow‐rate of 236 +/‐ 25 ml/min through a cuprophane membrane dialyser. 6 These results suggest that dosage should be modified for these patients.