Alteration of the pharmacokinetics of aminoglycosides by adsorption in a filter during continuous renal replacement therapy. An in vitro assessment

Filters used in continuous renal replacement therapy (CRRT) induce elimination by filtration, dialysis, and adsorption. The worldwide ST150® filter adsorbs cytokines. However, adsorption is a non-specific process which might alter the pharmacokinetics of drugs. Pharmacodynamic/pharmacokinetic relationship aminoglycosides evidences importance peak concentration at first dose. We hypothesize an vitro study may clarify routes using filter. Prismaflex® STX150® filter, Baxter-Gambro were used. diafiltration mode combined flowrates dialysis filtration 2.5/1.5 L/h, respectively, over 6 h. One ionic solute was different compartments. Pharmacokinetic analyses performed NeckEpur® software. Percentages gentamicin, tobramycin, amikacin eliminated from central compartment 97 ± 1, 95 3, 94 6, %, respectively. clearances 8.4 2.3, 5.4 5, 4.2 0.4 contributions for 34.3 2.1, 0 0, 67.7 2.1; 51.1 1.6, 6.3 3.1, 46.3 2.0, 37.8 6.3, 16.0 5.7%, Among physico-chemical properties, rate linearly inversely correlated with polar surface area (Y = ?0.44 X + 161.7; R2 0.9993). Using play role depending on chemical structure aminoglycosides. In mode, gentamicin tobramycin not detected or weak, Adsorption should be considered as potential adverse effect CRRT. Polar drugs parameter regarding filters. risk needs to systematically assessed.