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NDT Plus Advance Access published online on December 18, 2008
NDT Plus, doi:10.1093/ndtplus/sfn195
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© The Author [2008]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Severe adverse effects of 5-fluorouracil in S-1 were lessened by haemodialysis due to elimination of the drug

Kazunori Inoue, Yasuyuki Nagasawa, Ryohei Yamamoto, Hiroki Omori, Tomonori Kimura, Kodo Tomida, Yoshiyuki Furumatsu, Enyu Imai, Yoshitaka Isaka and Hiromi Rakugi

Department of Geriatric Medicine and Nephrology, Osaka University Graduate School of Medicine, Osaka, Japan

Correspondence: Kazunori Inoue, Department of Nephrology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka (B6), Suita-city, Osaka 565-0871, Japan. Tel: +81-6-6879-3632; Fax: +81-6-6879-3639; E-mail: kznri{at}kid.med.osaka-u.ac.jp


  Abstract

S-1 and cisplatin are used as one of the first-line chemotherapies for gastric cancer in Japan. The plasma concentration of 5-fluorouracil (5-FU) is increased in patients with renal dysfunction because gimeracil in S-1 inhibits the degradation of 5-FU and about 50% of gimeracil is excreted in the urine. We describe a 35-year-old man with acute kidney injury while taking S-1 and cisplatin for advanced gastric cancer and who presented severe adverse effects of 5-FU. This case report describes the evolution of the plasma concentrations of 5-FU with haemodialysis along with a decrease in the adverse drug effects.

Key Words: 5-fluorouracil • gimeracil • haemodialysis • S-1

Received for publication November 8, 2008. Accepted for publication November 24, 2008.


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