Effects of dialysis membrane on intradialytic vancomycin administration

Pharmacotherapy. Mar-Apr 1997;17(2):256-62.

Abstract

Study objective: To quantify the influence of hemodialyzers on vancomycin removal when the drug was infused during hemodialysis.

Design: Prospective, controlled, crossover study with three arms.

Setting: A university-affiliated medical center.

Patients: Eight subjects receiving outpatient hemodialysis.

Interventions: The three treatment arms were vancomycin 1000 mg infused after dialysis was completed (control), and the same dosages infused during the last hour of hemodialysis with a cellulose triacetate (CT) and a cellulose acetate (CA) hemodialyzer.

Measurements and main results: The areas under the curve from time zero to 44 hours (AUC0-44 hrs) for the three study arms were significantly different (p < 0.05), with the mean vancomycin AUC0-44 hrs being significantly lower when administered during CT and CA dialysis (73.7% and 87.2% of control; p < 0.05 vs control). The mean vancomycin peak concentration achieved during CT dialysis was significantly lower than for the CA and control arms (20.5, 23.9, 27.0 mg/L, respectively). Forty-four-hour postinfusion concentrations were similarly lower.

Conclusion: Clinicians should recognize that the composition of the hemodialyzer significantly influences vancomycin serum concentrations when the drug is administered during hemodialysis.

Publication types

  • Clinical Trial
  • Comparative Study
  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents / blood*
  • Anti-Bacterial Agents / pharmacokinetics
  • Anti-Bacterial Agents / therapeutic use
  • Cellulose / analogs & derivatives
  • Cross-Over Studies
  • Humans
  • Kidney Failure, Chronic / blood
  • Kidney Failure, Chronic / therapy*
  • Membranes, Artificial*
  • Permeability
  • Prospective Studies
  • Renal Dialysis / instrumentation
  • Renal Dialysis / methods*
  • Vancomycin / blood*
  • Vancomycin / pharmacokinetics
  • Vancomycin / therapeutic use

Substances

  • Anti-Bacterial Agents
  • Membranes, Artificial
  • acetylcellulose
  • Vancomycin
  • Cellulose
  • cellulose triacetate