Hepatic drug clearance in chronic liver disease: Can we expect to find a universal, quantitative marker of hepatic function?

Authors

  • Denis J. Morgan Ph.D.,

    1. Victorian College of Pharmacy Parkuille, Melbourne 3052 and University of Melbourne Austin Hospital Melbourne 3084 Victoria, Australia
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  • Richard A. Smallwood M.D., FRACP

    1. Victorian College of Pharmacy Parkuille, Melbourne 3052 and University of Melbourne Austin Hospital Melbourne 3084 Victoria, Australia
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Abstract

Blood clearance of antipyrine, indocyanine green, and galactose were measured to evaluate the alterations of effective hepatic blood flow and hepatic intrinsic clearances in chronic liver diseases. Galactose blood clearance, which may be taken as effective hepatic blood flow, decreased by approximately 30% in patients with cirrhosis (12.49 ± 0.76 ml/min/kg; mean ± SE; n = 17) compared with normal subjects (18.17 ± 1.03 ml/min/kg; n = 5). In patients with cirrhosis, intrinsic clearances of antipyrine (9.178 ± 0.14 ml/min/kg; n = 17) and indocyanine green (6.19 ± 1.38 ml/min/kg; n = 7) showed 61% and 85% reduction, respectively, compared with those of normal subjects (0.462 ± 0.048 ml/min/kg; n = 5; 41.72 ± 7.75 ml/min/kg; n = 5). Considering that indocyanine green and antipyrine are eliminated by different hepatic mechanisms, these mechanisms may not be equally sensitive to decrements in hepatic function. In addition, fractional reductions of intrinsic clearances for these compounds are thus much greater than that of effective hepatic blood flow.

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