5-氟尿嘧啶（5FU）注射是一种严重的高氨血症不良反应。血液透析可用于治疗，但关于5FU及其代谢产物在血液透析中的浓度和清除速率的详细数据尚不清楚。在这里，我们介绍了两例接受同时5FU输注的晚期肾病患者的血液透析病例。 第二天血液透析过程中，收集了血液样本，在透析器前后收集了血液循环中的样本，并在第四天血液透析过程中，在内部分流前后收集了样本。使用液相色谱串联质谱法测定了5FU及其代谢产物-α-氟-β-丙氨酸（FBAL）和单氟乙酸（FA）的血清水平。 对于病例1，收集了7组血样，透析器对5FU和FBAL的清除率（均值±标准差）分别为81.2%±23.2%和96.1%±8.6%（p＜0.001）。对于病例2，收集了3组血样，5FU和FBAL的清除率分别为81.7%±3.9%和94.8%±2.7%（p＝0.03）。对于病例1，收集了27组血样，FBAL和FA的血液水平减少分别为49.3%±8.8%（p＜0.001）和64.2%±30.3%（p＝0.04）。贝叶斯估计得到了类似的结果。对于病例2，收集了3组血样，FBAL和FA的血液水平减少分别为49.9%±6.9%和50.6%±33.0%。 在本研究中，血液透析可使5FU及其代谢产物FBAL在血液中直接清除约90%，单次血液透析过程中，FBAL和FA的血液水平减少约50%。© 2023. 作者。

Hyperammonemia is a serious adverse effect of 5-fluorouracil (5FU) administration. Hemodialysis can be used for its management, but detailed data on the concentrations and removal rate of 5FU and its metabolites during hemodialysis remain unclear. Here, we present two cases of hemodialysis patients with end-stage renal disease who received concurrent 5FU infusion.Blood samples were collected from the hemodialysis circuit before and after the dialyzer during day 2 hemodialysis sessions, and from the internal shunt just before and after day 4 hemodialysis sessions. The serum levels of 5FU and its metabolites-α-fluoro-β-alanine (FBAL) and monofluoroacetate (FA)-were measured using liquid chromatography-tandem mass spectrometry.Seven sets of blood samples were collected for case 1; the removal rates (mean ± standard deviation) of 5FU and FBAL by the dialyzer were 81.2 ± 23.2% and 96.1 ± 8.6%, respectively (p < 0.001). Three sets of blood samples were collected for case 2; the removal rates of 5FU and FBAL were 81.7 ± 3.9% and 94.8 ± 2.7%, respectively (p = 0.03). Twenty-seven sets of blood samples were collected for case 1; reductions in blood FBAL and FA levels were 49.3 ± 8.8% (p < 0.001) and 64.2 ± 30.3% (p = 0.04), respectively. Bayesian estimation yielded similar results. Three sets of blood samples were collected for case 2; reductions in the blood FBAL and FA levels were 49.9 ± 6.9% and 50.6 ± 33.0%, respectively.In this study, 5FU and its metabolite FBAL were directly removed from the blood by approximately 90% during hemodialysis, and the blood levels of FBAL and FA were reduced by approximately 50% with a single hemodialysis session.© 2023. The Author(s).