Gentamicin clearance during hemodialysis: A comparison of high-efficiency cuprammonium rayon and conventional cellulose ester hemodialyzers

Rajiv Agarwal, R. D. Toto

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

The advent of high-efficiency hemodialyzers has afforded improved efficiency of urea clearance; however, increased clearance of other substances, particularly antibiotics, also may occur, necessitating changes in clinical practice. Accordingly, we compared the efficiency of gentamicin removal using two different hemodialyzers, a conventional saponified cellulose ester (CD 135) and a high-efficiency cuprammonium rayon dialyzer (TAF 175L), in eight hospitalized patients undergoing antibiotic therapy for suspected or proven gram-negative infection. The rate of dialysis, estimated as the ratio of dialyzer urea clearance (K) to urea distribution volume (V) (K/V urea), and the total elimination rate constant (k) of gentamicin were measured during 17 hemodialysis treatments. The K/V urea for the two dialyzers, TAF 175L and CD 135, was 0.390 ± 0.024 hr-1 and 0.413 ± 0.129 hr-1 (P = NS), respectively. The TAF 175L hemodialyzer was almost twice as efficient in removing gentamicin as the CD 135: TAF 175, k = 0.263 ± 0.024 hr-1; CD 135, k - 0.132 ± 0.027 hr-1 (P <0.001). Moreover, the rate of dialysis (K/V urea) was correlated with k of gentamicin for the TAF 175L dialyzer (r2 = 0.50, P <0.02) but not for the CD 135 dialyzer. We conclude that dialyzer characteristics and the rate of dialysis (K/V urea) should be taken into consideration when determining the dosage of gentamicin in patients on hemodialysis.

Original languageEnglish (US)
Pages (from-to)296-299
Number of pages4
JournalAmerican Journal of Kidney Diseases
Volume22
Issue number2
StatePublished - 1993
Externally publishedYes

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Artificial Kidneys
Gentamicins
Cellulose
Renal Dialysis
Urea
Esters
Dialysis
Anti-Bacterial Agents
AM 160H
Therapeutics
Infection

ASJC Scopus subject areas

  • Nephrology

Cite this

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title = "Gentamicin clearance during hemodialysis: A comparison of high-efficiency cuprammonium rayon and conventional cellulose ester hemodialyzers",
abstract = "The advent of high-efficiency hemodialyzers has afforded improved efficiency of urea clearance; however, increased clearance of other substances, particularly antibiotics, also may occur, necessitating changes in clinical practice. Accordingly, we compared the efficiency of gentamicin removal using two different hemodialyzers, a conventional saponified cellulose ester (CD 135) and a high-efficiency cuprammonium rayon dialyzer (TAF 175L), in eight hospitalized patients undergoing antibiotic therapy for suspected or proven gram-negative infection. The rate of dialysis, estimated as the ratio of dialyzer urea clearance (K) to urea distribution volume (V) (K/V urea), and the total elimination rate constant (k) of gentamicin were measured during 17 hemodialysis treatments. The K/V urea for the two dialyzers, TAF 175L and CD 135, was 0.390 ± 0.024 hr-1 and 0.413 ± 0.129 hr-1 (P = NS), respectively. The TAF 175L hemodialyzer was almost twice as efficient in removing gentamicin as the CD 135: TAF 175, k = 0.263 ± 0.024 hr-1; CD 135, k - 0.132 ± 0.027 hr-1 (P <0.001). Moreover, the rate of dialysis (K/V urea) was correlated with k of gentamicin for the TAF 175L dialyzer (r2 = 0.50, P <0.02) but not for the CD 135 dialyzer. We conclude that dialyzer characteristics and the rate of dialysis (K/V urea) should be taken into consideration when determining the dosage of gentamicin in patients on hemodialysis.",
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