Pharmacokinetics of rosuvastatin in patients with end-stage kidney disease undergoing peritoneal dialysis

Patients undergoing dialysis treatment have a high incidence of dyslipidemia. Rosuvastatin is a potent statin drug that improves overall lipid profiles in dyslipidemic patients. However, the pharmacokinetics of rosuvastatin has not been studied in patients with end-stage kidney disease undergoing chronic peritoneal dialysis (PD). The goals of this study are to determine the pharmacokinetics and tolerability of a single oral dose of rosuvastatin in patients undergoing continuous ambulatory PD (CAPD). This was a nonrandomized, open-label, 1-week trial. Ten stable PD patients were given a single oral dose of rosuvastatin (10 mg). Serial blood samples were obtained over the next 48 hours, and the patients were followed for 1 week while they underwent CAPD. Rosuvastatin plasma concentration peaked (C-max) at 3.68 +/- 2.3 ng/ml (geometric mean), 4.5 hours (median; range 2 - 6 hours) after oral dosing. The plasma concentration of rosuvastatin was 0.44 +/- 0.23 ng/ml at 24 hours (C-24) and 0.14 +/- 0.07 ng/ml, with levels below the detectable range in 5 of 10 subjects, at 48 hours (C-48). The area under the plasma concentration-time from 0 to 48 hours (AUC(0-48)) was 32.6 +/- 1.6 ng/ml/h. These pharmacokinetic profiles of rosuvastatin in CAPD patients are very similar to those observed in healthy volunteers, but different from patients with Stages 4 - 5 chronic kidney disease. A single oral dose of rosuvastatin was well tolerated in this small number of patients. We conclude that pharmacokinetic profiles of rosuvastatin in patients undergoing CAPD are similar to those observed in healthy volunteers. These findings suggest that a lower dose of rosuvastatin (<= 10 mg) may be administered in CAPD patients without dose adjustment.