Pharmacokinetics of High Dose Methotrexate : 1 : In Acute Renal Failure

Abstract

Acute renal failure developed in a 5 year-old girl during the fifth course of high dose methotrexate (MTX) treatment for osteosarcoma. She showed oliguria, and the serum MTX concentration, BUN and Scr were 461 μmoles/1, 50 mg/dl and 2.6 mg/dl, respectively, at 27 hr after infusion.Massive leucovorin calcium rescure, direct hemoperfusion, hemodialysis and plasma exchange therapies were successfully treated and she recovered gradually.Neither toxic bone marrow suppression nor side effect of massive leucovorin calcium appeared.The pharmacokinetic analysis of MTX during the renal failure and the dialysis treatment was investigated.