Higher Renal Replacement Therapy Dose Delivery Influences on Drug Therapy

: Higher doses of renal replacement therapy have profound effects on pharmacotherapy, yet little research has been conducted in this area. High‐volume renal replacement therapies influence both the pharmacokinetic and the pharmacodynamic profiles of all drugs administered to these critically ill pat...

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Bibliographic Details
Published in:Artificial organs 2003-09, Vol.27 (9), p.808-814
Main Authors: Mueller, Bruce A., Pasko, Deborah A., Sowinski, Kevin M.
Format: Article
Language:English
Subjects:
Acute Kidney Injury - drug therapy
Acute Kidney Injury - therapy
Critical Illness
Dose-Response Relationship, Drug
Drug Prescriptions
Hemodialysis
Humans
Pharmacodynamics
Pharmacokinetics
Renal replacement therapy
Renal Replacement Therapy - methods
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Summary:: Higher doses of renal replacement therapy have profound effects on pharmacotherapy, yet little research has been conducted in this area. High‐volume renal replacement therapies influence both the pharmacokinetic and the pharmacodynamic profiles of all drugs administered to these critically ill patients. Intermittent high‐dose “hybrid” hemodialysis therapies remove drugs to a much different degree than standard thrice‐weekly hemodialysis, yet pharmacokinetic studies have not been performed in patients receiving these therapies. High‐volume continuous renal replacement therapies offer dosing challenges not seen with standard low‐dose therapies. This article describes the pharmacokinetic and pharmacodynamic issues presented by high‐volume renal replacement therapies. Given the importance that pharmacotherapy has on optimal patient outcomes, a better understanding of the influence that high‐volume renal replacement therapy has on drugs is essential if these high volume therapies are to be used successfully in the intensive care unit.
ISSN:0160-564X
1525-1594
DOI:10.1046/j.1525-1594.2003.07283.x