Plasma protein binding of fentanyl: the effect of hyperlipoproteinaemia and chronic renal failure

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Abstract
Hyperlipoproteinaemic patients with raised pre β-, or pre β- and β-lipoprotein fractions snowed a significant (P < 0.001) increase in binding of fentanyl to whole plasma, compared with normal subjects. The presence of chylomicra had no significant effect on binding. In patients with chronic renal failure, a correlation of probability P < 0.07 was found between percent binding and concentrations of pre β-lipoprotein (P = 0.001), serum albumin (P = 0.0101), total protein minus albumin (P = 0.0576) and β-lipoprotein (P = 0.0625). There was no significant correlation of binding with elevation of α- or γ-globulins, with urea or creatinine concentrations, or with age or sex (P ≥ 0.223). The magnitude of changes in the free fraction found in these patients should not produce a clinical effect as the total distribution volume of fentanyl exceeds 200 litres.