Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Concept Videos

Renal Failure: Dose Adjustments01:11

Renal Failure: Dose Adjustments

581
In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
581
Continuous Renal Replacement Therapy01:30

Continuous Renal Replacement Therapy

1.9K
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...
1.9K
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

313
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...
313
Acute Kidney Injury V: Interprofessional Care01:20

Acute Kidney Injury V: Interprofessional Care

479
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...
479
Drug Accumulation During Multiple Dosing: Intermittent IV Infusions01:24

Drug Accumulation During Multiple Dosing: Intermittent IV Infusions

350
Intermittent intravenous (IV) infusion is a method of drug administration where medications are delivered over short infusion periods followed by intervals of no drug delivery. This approach helps to prevent sustained high drug concentrations in the bloodstream, reducing the risk of adverse effects associated with prolonged exposure. Unlike continuous infusion, steady-state concentrations may not be achieved during a single dosing cycle but can be reached through repeated...
350
Acute Kidney Injury VI: Nursing Management01:22

Acute Kidney Injury VI: Nursing Management

686
Acute Kidney Injury (AKI) results in an inability to maintain fluid, electrolyte, and acid-base balance. Effective nursing management is critical in improving patient outcomes and includes comprehensive patient assessment and targeted interventions.Comprehensive Patient AssessmentA detailed history collection is essential, focusing on any recent infections, nephrotoxic medication use, or chronic conditions such as hypertension and diabetes that may contribute to AKI. During the physical...
686

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

Severe Pregnancy-Associated Acute Kidney Injury and Maternal Vulnerability.

Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association·2026
Same author

Clinical Predictors of Fatal Outcomes from Human Leptospirosis, Thailand, 2015-2024.

Emerging infectious diseases·2026
Same author

Population pharmacokinetics of unbound imipenem in critically ill patients: a comparison of five renal function estimators for PK/PD-guided dosing.

European journal of clinical pharmacology·2026
Same author

Advantages of artificial saliva containing Cuminum cyminum and Zingiber officinale on hemodialysis patients with xerostomia: Randomized clinical trials.

Explore (New York, N.Y.)·2026
Same author

Authors reply: "Development and internal validation of machine learning in predicting prognosis of acute kidney injury patients in resource-limited setting".

Journal of critical care·2026
Same author

Acute kidney injury in urological conditions.

Asian biomedicine : research, reviews and news·2026

Related Experiment Video

Updated: Apr 1, 2026

Surgical Techniques for Catheter Placement and 5/6 Nephrectomy in Murine Models of Peritoneal Dialysis
07:11

Surgical Techniques for Catheter Placement and 5/6 Nephrectomy in Murine Models of Peritoneal Dialysis

Published on: July 19, 2018

16.2K

Meropenem Dosing Recommendations in Critically Ill Patients Receiving Prolonged Intermittent Renal Replacement

Jirapat Vamananda1,2, Weerachai Chaijamorn1,2, Taniya Charoensareerat3

  • 1Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand.

Nephrology (Carlton, Vic.)
|March 30, 2026
PubMed
Summary

Optimizing meropenem dosing for critically ill patients on prolonged intermittent renal replacement therapy (PIRRT) is crucial. This study recommends specific daily meropenem doses (2000-3000 mg) for PIRRT to ensure effective treatment outcomes.

Keywords:
Monte Carlo simulationcritically ill patientmeropenempharmacokineticsprolonged renal replacement therapy

More Related Videos

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

5.0K
Noninvasive and Invasive Renal Hypoxia Monitoring in a Porcine Model of Hemorrhagic Shock
07:48

Noninvasive and Invasive Renal Hypoxia Monitoring in a Porcine Model of Hemorrhagic Shock

Published on: October 28, 2022

1.7K

Related Experiment Videos

Last Updated: Apr 1, 2026

Surgical Techniques for Catheter Placement and 5/6 Nephrectomy in Murine Models of Peritoneal Dialysis
07:11

Surgical Techniques for Catheter Placement and 5/6 Nephrectomy in Murine Models of Peritoneal Dialysis

Published on: July 19, 2018

16.2K
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

5.0K
Noninvasive and Invasive Renal Hypoxia Monitoring in a Porcine Model of Hemorrhagic Shock
07:48

Noninvasive and Invasive Renal Hypoxia Monitoring in a Porcine Model of Hemorrhagic Shock

Published on: October 28, 2022

1.7K

Area of Science:

  • Pharmacology
  • Critical Care Medicine
  • Nephrology

Background:

  • Meropenem dosing requires optimization in critically ill patients undergoing prolonged intermittent renal replacement therapy (PIRRT).
  • Limited data exists on achieving therapeutic meropenem concentrations during PIRRT.
  • Accurate dosing is essential for effective antimicrobial therapy and preventing resistance.

Purpose of the Study:

  • To evaluate the probability of target attainment (PTA) for various meropenem dosing regimens in critically ill patients on PIRRT.
  • To determine optimal meropenem dosage strategies using Monte Carlo simulations (MCS).
  • To provide evidence-based recommendations for meropenem administration during PIRRT.

Main Methods:

  • Developed pharmacokinetic (PK) models based on published data from critically ill patients.
  • Simulated meropenem dosing using MCS across different PIRRT modalities (haemodialysis [HD] and hemofiltration [HF]) with varying session durations (4-10 hours).
  • Assessed pharmacodynamic (PD) targets: free meropenem concentrations above 4x the minimum inhibitory concentration (MIC) of 2 mg/L.

Main Results:

  • Specific meropenem dosing regimens were identified for alternate-day and daily PIRRT, considering HD and HF modalities.
  • For daily PIRRT, recommended doses ranged from 750 mg every 8 hours to 1000 mg every 8 or 12 hours, depending on modality and session duration.
  • Optimal regimens achieved ≥90% PTA, with specific recommendations provided for various PIRRT scenarios.

Conclusions:

  • Optimized daily meropenem doses of 2000-3000 mg are recommended for PIRRT to ensure safe and effective outcomes.
  • The study provides specific dosing guidance for different PIRRT modalities and durations.
  • Further clinical validation is necessary before widespread implementation of these meropenem dosing strategies.