Optimization of Anti-infective Dosing Regimens During Online Haemodiafiltration

Overview

Journal Clin Kidney J

Publisher Oxford University Press

Specialty Nephrology

Date 2017 Apr 12

PMID 28396747

Citations 4

Authors

Nynke G L Jager

Anthe S Zandvliet

Daniel J Touw

Erik L Penne

Affiliations

Soon will be listed here.

Abstract

Online haemodiafiltration (HDF) is increasingly used in clinical practice as a routine intermittent dialysis modality. It is well known that renal impairment and renal replacement therapy can substantially affect the pharmacokinetic behaviour of several drugs. However, surprisingly few data are available on the need for specific dose adjustments during HDF. Due to convection, drug clearance may be increased during HDF as compared with standard haemodialysis. This may be of particular interest in patients undergoing anti-infective therapy, since under-dosing may compromise patient outcomes and promote the emergence of bacterial resistance. Drug clearance during HDF is determined by (i) dialysis characteristics, (ii) drug characteristics and (iii) patient characteristics. In this review, we will discuss these different determinants of drug clearance during HDF and advise on how to adjust the dose of antibacterial, antimycotic and antiviral agents in patients undergoing HDF. In addition, the possible added value of therapeutic drug monitoring is discussed. The review provides guidance for optimization of anti-infective dosing regimens in HDF patients.

Citing Articles

Ertapenem-induced neurotoxicity in an end-stage renal disease patient on intermittent haemodialysis: a case report.

Shahar S, Arimuthu D, Mazlan S BMC Nephrol. 2022; 23(1):360.

PMID: 36348388 PMC: 9644511. DOI: 10.1186/s12882-022-02980-8.

Optimising the Nadroparin Dose for Thromboprophylaxis During Hemodialysis by Developing a Population Pharmacodynamic Model Using Anti-Xa Levels.

Jaspers T, Meijer C, Vleming L, Franssen C, Diepstraten J, Lukens M Clin Pharmacokinet. 2022; 61(11):1559-1569.

PMID: 36040615 PMC: 9652168. DOI: 10.1007/s40262-022-01162-x.

Vancomycin pharmacokinetic model development in patients on intermittent online hemodiafiltration.

Westra N, Proost J, Franssen C, Wilms E, van Buren M, Touw D PLoS One. 2019; 14(5):e0216801.

PMID: 31086400 PMC: 6516654. DOI: 10.1371/journal.pone.0216801.

Clinical evidence on haemodiafiltration.

Blankestijn P, Grooteman M, Nube M, Bots M Nephrol Dial Transplant. 2018; 33(suppl_3):iii53-iii58.

PMID: 30281128 PMC: 6168838. DOI: 10.1093/ndt/gfy218.

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