Pharmacokinetics of netilmicin during hemodialysis: comparison of four artificial kidneys

The pharmacokinetics of netilmicin was studied in 11 patients with terminal renal impairment (Clcr less than 5 ml/min) during the course of a 4-h hemodialysis session, using four different kinds of dialyzer: Biospal 2400, Biospal 3000, Allegro HF, and Andante HF. All patients received a single dose of 2 mg netilmicin/kg body wt at the beginning of the dialysis session. The type of dialyzer influences the serum half-life, the dialysis clearance and the percentage of drug extracted during dialysis. A linear relationship was established between the drug fraction extracted by dialysis and the dialysis clearance of the antibiotic. During the hemodialysis sessions, the serum half-life of netilmicin decreased approximately 10-fold compared with the interdialysis periods.