Clearance of Gentamicin during Hemodialysis: Comparison of Four Artificial Kidneys

The effects of four types of artificial kidney on dialyzer clearance rates and serum pharmacokinetics of gentamicin were compared. In 19 patients undergoing chronic hemodialysis, the mean (± se) interdialysis half-life of gentamicin in serum was 49.3 ± 3.5 hr, whereas during dialysis this value was...

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Bibliographic Details
Published in:The Journal of infectious diseases 1976-06, Vol.133 (6), p.627-636
Main Authors: Halpren, Benjamin A., Axline, Stanton G., Coplon, Norman S., Brown, Debera M.
Format: Article
Language:English
Subjects:
Anti-Bacterial Agents - blood
Antibiotics
Artificial kidneys
Blood flow
Blood Flow Velocity
Blood plasma
Dialysis
Dosage
Drug Therapy, Combination
Flow velocity
Gentamicins - administration & dosage
Gentamicins - antagonists & inhibitors
Gentamicins - blood
Glomerular Filtration Rate
Half-Life
Humans
Kidneys
Kidneys, Artificial - instrumentation
Magnetohydrodynamic flow
Major Articles
Metabolic Clearance Rate
Renal clearance
Renal Dialysis
Urea - blood
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Summary:The effects of four types of artificial kidney on dialyzer clearance rates and serum pharmacokinetics of gentamicin were compared. In 19 patients undergoing chronic hemodialysis, the mean (± se) interdialysis half-life of gentamicin in serum was 49.3 ± 3.5 hr, whereas during dialysis this value was reduced to 10.0 ± 0.7 hr. The mean half-life of gentamicin in serum at conventional flow rates for the Hollow Fiber Kidney, Kiil, Gambro, and Coil dialyzers was 11.3, 10.9, 8.2, and 7.4 hr, respectively, and the mean values for clearance of gentamicin were 26, 28, 42, and 48 ml per min, respectively. For all dialyzers, rates of clearance of gentamicin increased linearly with plasma flow rate over the flow range studied. The Gambro and Coil dialyzers had significantly higher rates of clearance of gentamicin from serum (P > 0.05) than the Hollow Fiber Kidney and Kiil dialyzers over a wide range of clinically useful plasma flow rates (119–300 ml per min), whereas the Kiil dialyzer cleared gentamicin more effectively (P > 0.05) than the Hollow Fiber Kidney dialyzer over a more limited interval (117–177 ml per min). Therapeutic recommendations for patients undergoing hemodialysis were made in light of current findings.
ISSN:0022-1899
1537-6613
DOI:10.1093/infdis/133.6.627