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Related Concept Videos

Continuous Renal Replacement Therapy01:30

Continuous Renal Replacement Therapy

Continuous Renal Replacement Therapy, also known as CRRT, is a procedural treatment for acute kidney injury (AKI) that gradually removes uremic toxins and fluids while maintaining acid-base balance and stabilizing electrolytes. It is particularly useful for hemodynamically unstable patients. Unlike intermittent hemodialysis, which is faster, CRRT provides a gentler approach over 24 hours, closely mimicking the function of natural kidneys. However, CRRT is not ideal for patients with...
Extracorporeal Removal of Drugs: Continuous Renal Replacement Therapy01:26

Extracorporeal Removal of Drugs: Continuous Renal Replacement Therapy

Continuous Renal Replacement Therapy (CRRT) is an essential intervention for patients experiencing severe kidney dysfunction. This therapy offers a continuous mechanism for removing fluids and toxins from the bloodstream, leveraging the patient’s blood pressure to facilitate filtration through a specialized filter. This method contrasts with intermittent dialysis, providing a gentler and more consistent removal of waste products and excess fluid, which is particularly beneficial in critically...
Acute Kidney Injury V: Interprofessional Care01:20

Acute Kidney Injury V: Interprofessional Care

Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...
Renal Drug Clearance: Overview01:06

Renal Drug Clearance: Overview

Renal clearance is a crucial parameter in pharmacokinetics that quantifies the rate at which the kidneys excrete a drug. It represents a constant fraction of the central volume of distribution containing the drug that the kidney eliminates per unit of time.
Renal clearance can be calculated using different methods. One approach is to divide the urinary drug excretion rate by the plasma drug concentration. This method directly measures renal clearance, indicating the kidneys' efficiency in...
Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant01:25

Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant

In patients with renal disease, dosage adjustments are necessary to maintain therapeutic plasma drug concentrations and prevent toxicity or subtherapeutic exposure. Renal impairment alters drug pharmacokinetics, especially in conditions like uremia, where changes such as prolonged elimination half-life and altered apparent volume of distribution can significantly affect drug disposition. These changes require careful modification of the dosing regimen to achieve the desired clinical...
Renal Clearance01:23

Renal Clearance

The glomerular filtration rate (GFR) is a critical marker of kidney function, reflecting the efficiency of filtration by the glomeruli. Renal clearance of specific substances, such as inulin or creatinine, is commonly used to measure GFR.
Renal clearance refers to the volume of plasma cleared of a specific substance, such as creatinine, per unit of time. To measure clearance, urine samples are collected over a 24-hour period during each bladder voiding, followed by a single blood sample at the...

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Related Experiment Video

Updated: Jun 26, 2026

A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion
09:02

A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion

Published on: February 2, 2021

Ertapenem clearance during modeled continuous renal replacement therapy.

J M Stevenson1, J H Patel, M D Churchwell

  • 1Department of Clinical, Social and Administrative Sciences, College of Pharmacy, University of Michigan, Ann Arbor, Michigan 48109-1065, USA.

The International Journal of Artificial Organs
|December 31, 2008
PubMed
Summary

Ertapenem clearance during continuous renal replacement therapy (CRRT) varies by filter type and flow rate. Dosage adjustments may be needed in patients undergoing CRRT based on these findings.

Related Experiment Videos

Last Updated: Jun 26, 2026

A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion
09:02

A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion

Published on: February 2, 2021

Area of Science:

  • Pharmacokinetics
  • Nephrology
  • Critical Care Medicine

Background:

  • Continuous renal replacement therapy (CRRT) is crucial for managing critically ill patients with kidney injury.
  • Antibiotic dosing in CRRT requires careful consideration due to altered drug clearance.
  • Ertapenem is a carbapenem antibiotic with important clinical applications.

Purpose of the Study:

  • To quantify ertapenem transmembrane clearance (CLtm) in vitro during CRRT.
  • To compare ertapenem clearance using different hemodiafilter types and flow rates.
  • To assess the impact of CRRT parameters on ertapenem sieving and saturation coefficients.

Main Methods:

  • An in vitro model simulating continuous hemofiltration and hemodialysis was utilized.
  • Ertapenem and urea clearance were measured across AN69 and polysulfone hemodiafilters.
  • Experiments were conducted at varying dialysate and ultrafiltration rates (1-6 L/hour).

Main Results:

  • Ertapenem and urea showed high sieving coefficients (SC) in hemofiltration, with no significant difference between filter types.
  • In hemodialysis, ertapenem saturation coefficients (SA) and CLtm differed significantly between AN69 and polysulfone filters at high dialysate flow rates.
  • AN69 filter SA decreased with increasing dialysate flow, while polysulfone filter SA remained consistent.

Conclusions:

  • Ertapenem is substantially cleared in in vitro CRRT models.
  • Observed ertapenem SC and SA in CRRT models may differ from published unbound fractions.
  • In vivo validation is needed to confirm these findings and guide potential ertapenem dosage adjustments in CRRT patients.