Removal of acyclovir during continuous veno-venous hemodialysis and hemodiafiltration with high-efficiency membranes.
We present a critically ill patient with severe renal failure and anuria who underwent hemodialysis (HD), continuous veno-venous hemodialysis (CVVHD) and continuous veno-venous hemodiafiltration (CVVHDF) at different occasions, with 2 commonly used high-efficiency dialyzers (F-8 and CA-210), while receiving i.v. acyclovir. We estimate that during 24 hours of CVVHD with F-8 dialyzer approximately 18% and during 24 hours of CVVHDF with CA-210 dialyzer approximately 65% of the daily administered acyclovir is removed. This is comparable to the amount removed during 4 6 hours of HD, as reported previously. The percentage acyclovir extraction was 84% and 60% during CVVHD and CVVHDF with F-8 and CA-210 dialyzers, respectively. Acyclovir clearance during CVVHD was 14 ml/min and during CVVHDF was 17 ml/min, with F-8 and CA-210 dialyzers, respectively. Acyclovir half-life was 22.5 and 25.5 hours in 2 occasions off any type of renal replacement therapy, and it was 19.5 hours during CVVHDF with CA-210 dialyzer.
Khajehdehi
P
P
Department of Internal Medicine, Saint Louis University School of Medicine, MO, USA.
Jamal
J A
JA
Bastani
B
B
D058186:Acute Kidney Injury / Q000628:therapy; D000212:Acyclovir / Q000493:pharmacokinetics*; D001002:Anuria / Q000628:therapy; D005260:Female; D006440:Hemofiltration / Q000379:methods*; D006801:Humans; D016030:Kidney Transplantation / Q000502:physiology; D008875:Middle Aged; D006435:Renal Dialysis / Q000379:methods*; D014184:Transplantation, Homologous / Q000473:pathology
D000212:Acyclovir