Clinical use of ganciclovir during renal failure and continuous hemodialysis.
OBJECTIVE
Data is scarce concerning ganciclovir, used in CMV-related diseases in transplant patient with renal failure, especially when dialysis is necessary.


METHODS
Prospective trial.


METHODS
Intensive care unit in a university hospital, and pharmacy laboratory.


METHODS
pharmacokinetics were obtained in 3 patients undergoing continuous veno-venous hemodialysis (CVVHD) (PAN 69).


METHODS
HPLC measurements of plasmatic and ultrafiltrated ganciclovir were determined at 17 times intervals after a 5 mg/kg every 48 h dosage.


RESULTS
Peak and trough concentrations were respectively 16.1 +/- 2.4 and 5.5 +/- 0.5 mg/l, sieving coefficient 0.75-0.95, and volume of distribution at steady state 0.64 +/- 0.09 l/kg, half life (beta phase) 18.6 +/- 1.8 h. No direct toxicity, or CMV-related death occurred.


CONCLUSIONS
Plasma concentrations were higher than the ID 90. A dosage of 5 mg/kg/48 h of ganciclovir could be used during CVVHD, and ideally adjusted to monitoring of plasma drug levels.
Bastien
O
O
DAR-Intensive Care Unit, Hôpital Cardiologique et Pneumologique, Lyon, France.
Boulieu
R
R
Bleyzac
N
N
Estanove
S
S
D002851:Chromatography, High Pressure Liquid; D003131:Combined Modality Therapy; D003586:Cytomegalovirus Infections / Q000097:blood / Q000453:epidemiology / Q000628:therapy; D004341:Drug Evaluation; D015774:Ganciclovir / Q000008:administration & dosage* / Q000097:blood / Q000493:pharmacokinetics; D016027:Heart Transplantation; D006801:Humans; D016014:Linear Models; D016040:Lung Transplantation; D006435:Renal Dialysis; D051437:Renal Insufficiency / Q000097:blood / Q000453:epidemiology / Q000628:therapy*; D013997:Time Factors
D015774:Ganciclovir