Related Experiment Video

Updated: Feb 15, 2026

Direct Drug Delivery to Kidney via the Renal Artery
11:18

Direct Drug Delivery to Kidney via the Renal Artery

Published on: April 17, 2021

8.3K

Modified Colistin Regimen for Critically Ill Patients with Acute Renal Impairment and Continuous Renal Replacement

Pierantonio Menna1, Emanuela Salvatorelli, Alessia Mattei

  • 1Clinical Pharmacology Unit, University Hospital Campus Bio-Medico of Rome, Rome, Italy.

Chemotherapy
|January 16, 2018
PubMed

Insights

Colistin methanesulfonate (CMS) dosing may be insufficient for patients with kidney impairment undergoing continuous renal replacement therapy. A modified regimen with a higher loading dose shows potential for improved efficacy in treating multidrug-resistant infections.

Area of Science:

  • Pharmacology
  • Nephrology
  • Infectious Diseases

Background:

  • Colistin is a critical antibiotic for treating multidrug-resistant Gram-negative bacterial infections.
  • Colistin is administered as an inactive prodrug, colistin methanesulfonate (CMS).
  • Patients with acute kidney impairment on continuous renal replacement therapy (CRRT) may experience significant extracorporeal clearance of active colistin, potentially reducing treatment effectiveness.

Purpose of the Study:

  • To evaluate a modified CMS dosing regimen for patients with acute kidney impairment on CRRT.
  • To assess the feasibility and efficacy of a higher loading dose of CMS in this patient population.

Main Methods:

  • A modified dosing regimen was proposed: a loading dose of 9 MU (Milliunits) of CMS, followed by maintenance doses of 3 MU every 8 hours.
  • Preliminary pharmacokinetic data were collected and analyzed for two patients receiving this modified regimen.

Main Results:

  • The modified regimen involved a higher initial bolus of CMS compared to the conventional dose.
  • Preliminary pharmacokinetic evidence suggests the feasibility and potential efficacy of the proposed modified CMS regimen in the studied patients.

Conclusions:

  • Current CMS dosing may be inadequate for patients with acute kidney impairment undergoing CRRT.
  • A modified regimen with an increased loading dose of CMS warrants further investigation for optimizing colistin therapy in critically ill patients with renal dysfunction.
Keywords:
Area under the curveColistinLoading doseMinimum inhibitory concentration

More Related Videos

Technical Refinement of a Bilateral Renal Ischemia-Reperfusion Mouse Model for Acute Kidney Injury Research03:13

Technical Refinement of a Bilateral Renal Ischemia-Reperfusion Mouse Model for Acute Kidney Injury Research

Published on: November 3, 2023

3.1K
Early Detection of Drug-Induced Renal Hemodynamic Dysfunction Using Sonographic Technology in Rats06:38

Early Detection of Drug-Induced Renal Hemodynamic Dysfunction Using Sonographic Technology in Rats

Published on: March 11, 2016

12.6K

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...
1.2K
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...
237
Factors Affecting Renal Clearance: Renal Impairment01:17

Factors Affecting Renal Clearance: Renal Impairment

Renal dysfunction significantly impairs the renal clearance of drugs, leading to potential complications in drug therapy. Renal failure, which can be caused by various factors, poses a significant challenge in the elimination of drugs from the body.
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
503
Renal Corpuscle01:20

Renal Corpuscle

The glomerulus and Bowman's capsule are two essential components of the nephron, which is the functional unit of the kidney. These microscopic structures play a critical role in the process of blood filtration to produce urine.
Glomerulus: Structure and Function
The glomerulus is a tiny, intricate network of capillaries located at the beginning of the nephron. It's enveloped by the Bowman's capsule and receives its blood supply from an afferent arteriole, which divides into numerous...
7.7K
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...
2.8K
Renal Drug Clearance: Comparison Between Renal Excretion Methods01:08

Renal Drug Clearance: Comparison Between Renal Excretion Methods

Renal clearance is a critical parameter encompassing kidney filtration, secretion, and reabsorption processes. It is calculated using a specific equation to determine the rate at which the kidneys clear a drug.
Renal clearance is often associated with the renal glomerular filtration rate (GFR), which represents the rate at which plasma is filtered through the glomeruli in the kidney. When drug reabsorption is minimal and there is no active secretion, renal clearance is closely related to the...
660