Korean J Nephrol.  2006 Jul;25(4):595-601.

Removal of Amikacin in Patients Undergoing Continuous Venovenous Hemodiafiltration

• Moon SY
• Oh KH
• Oh YK
• Ann C
• Joo KW
• Kim YS
• Han JS
• Kim S
• Lee JS
• Kim JR
• Yu KS
• Jang IJ
• Shin SG

Abstract

BACKGROUND: The purpose of this study was to investigate the pharmacokinetics of amikacin in critically ill patients undergoing continuous venovenous hemodiafiltration (CVVHDF).
METHODS
Pharmacokinetic parameters in each of six renal failure patients were estimated by measurement of amikacin levels in serum and effluent samples.
RESULTS
Average clearance of amikacin by CV VHDF was 28.5+/-4.6 mL/min (mean+/-standard deviation). The sieving coefficient was 0.62+/-0.2 in the hemodiafiltration system of Gambro AN69 membrane set. Volume of distribution of amikacin was estimated to be 0.47+/-0.08 L/kg lean body weight. The half-life of amikacin was significantly reduced by hemodiafiltration to 11.4+/-1.6 hr. 40% of the administered amikacin was removed by CVVHDF over the 24 hour study period.
CONCLUSION
We recommend that 10 mg/kg of amikacin should be given i.v. every 48 hours to critically ill patients during CVVHDF. However, individualized approach based on therapeutic drug monitoring of plasma amikacin concentration is necessary for optimum amikacin therapy during CVVHDF due to the varying nature of critically ill patients.

Keyword

Amikacin; Pharmacokinetics; CVVHDF; CRRT; Renal failure

MeSH Terms

Amikacin*
Body Weight
Critical Illness
Drug Monitoring
Half-Life
Hemodiafiltration*
Humans
Membranes
Pharmacokinetics
Plasma
Renal Insufficiency
Amikacin