Efficacy of hemodialysis and the effects of certain displacing agents on plasma protein binding of sulfamethoxazole and sulfaphenazole in patients with chronic renal failure.

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Abstract
The binding of sulfamethoxazole [SMX] and sulfaphenazole [SPH] to the plasma protein of 7 patients with chronic renal failure, undergoing chronic hemodialysis, was studied by the equilibrium dialysis method and the results were compared with those for 12 normal subjects. The binding percentages of the 2 sulfonamides were impaired in the patient''s plasma as compared with normal plasma. The binding percentages increased in the patients'' plasma after hemodialysis except in the cases of 2 patients for SMX and 1 patient for SPH. The effect of hemodialysis on drug protein binding was examined by calculating the percentage displacement of bound sulfonamides by oxyphenbutazone and sulfinpyrazone. Percentage displacements were higher in the patients'' plasma than in normal plasma. The percentage displacement decreased in the patients'' plasma after hemodialysis, except in the case of 1 patient for SMX and 1 patient for SPH. The drug binding activity of plasma albumin can apparently be improved through hemodialysis for patients with chronic renal failure.