Determination of vancomycin and gentamicin clearance in an in vitro, closed loop dialysis system

BMC Nephrology

Darren W Grabe²  Darius L Mason²  Thomas D Nolin¹  Katie E Cardone³  Soo Min Jang⁴ 

[1] Department of Pharmacy and Therapeutics, University of Pittsburgh School of Pharmacy, 3501 Terrace Street, Pittsburgh 15261, PA, USA;Albany College of Pharmacy and Health Sciences, 106 New Scotland Avenue, Albany 12208, NY, USA;Department of Pharmacy Practice, Albany Nephrology Pharmacy Group (ANephRx), Albany College of Pharmacy and Health Sciences, 106 New Scotland Avenue, Albany 12208, NY, USA;Department of Pharmacy Practice, Albany College of Pharmacy and Health Sciences, 106 New Scotland Avenue, Albany 12208, NY, USA

关键词: Clearance;    Gentamicin;    Vancomycin;    in vitro system;    Hemodialysis;   

Others  :  1083478
DOI  :  10.1186/1471-2369-15-204

 received in 2014-03-26, accepted in 2014-11-13,  发布年份 2014

【 摘 要 】

Background

The purpose of this study was to evaluate the feasibility of utilizing an in-vitro, closed loop hemodialysis system as a method to assess drug clearance. Secondarily, this study tested the influence of variables (blood flow rate, dialysate flow rate, and type of filter) in the hemodialysis procedure on the clearance of vancomycin and gentamicin.

Methods

An in-vitro, closed loop hemodialysis system was constructed. The vancomycin (30 mg/L) and gentamicin (25 mg/L) were added to a simulated blood system (SBS). Four conditions (C1-C4) were tested by defining the filter (Polyflux 170H or F180) and the blood and dialysate flow rates (BFR and DFR). All hemodialysis sessions were 3 hours in length and each condition was completed in duplicate. Dialysate effluent was collected in a 50 gallon polyethylene drum. Samples were collected (in duplicate) from the SBS and the dialysate effluent at baseline and at the end of the hemodialysis session. Samples were analyzed for vancomycin and gentamicin with an ultrahigh performance liquid chromatography/tandem mass spectrometry method.

Results

A total of eight 3-hour hemodialysis sessions were conducted. For all tested conditions (C1-C4), vancomycin was undetectable in the SBS at the end of dialysis. However, total vancomycin recovery in the dialysis effluent was 85±18%, suggesting that up to 15% may have adsorbed to the dialysis filter or tubing. Gentamicin clearance from SBS was >98% in all tested conditions. Average gentamicin recovery in the dialysate effluent was 99±15%.

Conclusion

Both vancomycin and gentamicin were readily removed by high-flux hemodialysis under all conditions studied. No significant differences in drug clearance were observed between conditions used in this in vitro study. The clinical implications of changing these hemodialysis parameters are unknown.

【 授权许可】

   
2014 Jang et al.; licensee BioMed Central Ltd.

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