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CAHP-210 dialyzer influence on intra-dialytic vancomycin removal
Aroonrut Lucksiri1, Meri K Scott, Bruce A Mueller
1Department of Pharmacy Practice, School of Pharmacy and Pharmacal Sciences, Purdue University, Indianapolis 46202, USA.
Summary
Administering vancomycin during hemodialysis with the CAHP-210 dialyzer removes 24% of the drug. This significant intra-dialytic vancomycin removal impacts dosing strategies for patients with end-stage renal disease.
Area of Science:
- Pharmacokinetics
- Nephrology
- Clinical Pharmacy
Background:
- Vancomycin dosing is complex in hemodialysis patients.
- Older hemodialyzers showed minimal vancomycin removal.
- Newer hemodialyzers exhibit variable vancomycin removal rates.
Purpose of the Study:
- To quantify vancomycin removal during hemodialysis using a CAHP-210 hemodialyzer.
- To assess the impact of intra-dialytic administration on vancomycin exposure.
Main Methods:
- Eight end-stage renal disease (ESRD) patients received intravenous vancomycin.
- Serum vancomycin concentrations were measured serially for 44 hours.
- Pharmacokinetic analysis estimated apparent vancomycin removal during dialysis.
Main Results:
- The CAHP-210 hemodialyzer removed a median of 24% of vancomycin intra-dialytically.
- This removal was statistically significant (p<0.05).
- Individual patient removal varied from -7% to 35%.
Conclusions:
- Vancomycin administered during the last hour of CAHP-210 dialysis leads to reduced drug exposure.
- Intra-dialytic vancomycin loss must be considered for accurate dosing.
- This finding is crucial for optimizing vancomycin therapy in ESRD patients undergoing hemodialysis.