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Drug elimination by hemofiltration.

K W Rumpf, J Rieger, B Doht

    Journal of Dialysis
    |January 1, 1977
    PubMed
    Summary
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    Hemofiltration effectively removes several drugs, including doxycycline and sulfamethoxazole, in patients with chronic renal insufficiency. However, gentamicin elimination was lower than expected, potentially due to membrane polarization during treatment.

    Area of Science:

    • Pharmacokinetics
    • Nephrology
    • Biomedical Engineering

    Background:

    • Chronic renal insufficiency impacts drug elimination.
    • Understanding drug clearance during hemofiltration is crucial for optimizing patient treatment.
    • Several common antibiotics and other drugs are frequently used in patients with kidney disease.

    Purpose of the Study:

    • To quantify the elimination of gentamicin, doxycycline, ampicillin, sulfamethoxazole, and clofibrate by hemofiltration in patients with chronic renal insufficiency.
    • To compare measured drug clearance with predicted values based on protein binding.
    • To investigate potential mechanisms affecting drug elimination during hemofiltration.

    Main Methods:

    • Hemofiltration was performed on patients with chronic renal insufficiency.

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  • Drug concentrations in plasma and filtrate were measured to determine clearance.
  • Calculated clearance values were compared to drug protein binding data.
  • Filtered fraction over time was analyzed for gentamicin and doxycycline.

    • Main Results:

    • Ampicillin and clofibrate elimination aligned with predictions based on protein binding.
    • Doxycycline and sulfamethoxazole showed higher-than-expected elimination rates.
    • Gentamicin clearance was lower than predicted, despite its protein binding.
    • A linear increase in the filtered fraction over time was observed for gentamicin and doxycycline.

    Conclusions:

    • Hemofiltration is an effective method for removing doxycycline and sulfamethoxazole in renal insufficiency.
    • Gentamicin elimination during hemofiltration may be influenced by factors beyond protein binding, such as membrane polarization.
    • Further research is needed to fully understand drug-membrane interactions during hemofiltration.