Modeled dalbavancin transmembrane clearance during intermittent and continuous renal replacement therapies.
OBJECTIVE
Knowledge of dalbavancin renal replacement therapy (RRT) disposition is vital to ensure appropriate dosing. In vitro models of continuous RRT and intermittent hemodialysis (IHD) were used to determine dalbavancin transmembrane clearance (CLtm).


METHODS
Dalbavancin saturation and sieving coefficients (SCs) were determined for hemodialysis and hemofiltration therapies, respectively, using various hemodiafilter and effluent rate combinations. Dalbavancin CLtm estimates were calculated from observed saturation and SCs.


RESULTS
Saturation and SCs for both modalities of continuous dialysis and hemofiltration and IHD with high permeability hemodiafilters were small. Nonetheless, during continuous RRT with high dialysate and ultrafiltration rates, dalbavancin CLtm (0.20-1.26 ml/min) matched and often exceeded literature-derived dalbavancin renal clearances. Dalbavancin CLtm was undetectable during IHD with low-permeability hemodialyzers, but with high-permeability hemodialyzers, substantial CLtm (1.90-2.43 ml/min) was noted.


CONCLUSIONS
Dalbavancin CLtm is dependent on RRT modality, hemodiafilter, and effluent flow. Dalbavancin doses may need to be adjusted depending on RRT parameters.
Vilay
A Mary
AM
Department of Pharmacy and Pharmacology, University of Bath, Bath, UK. mvilay@salud.unm.edu
Shah
Krishna H
KH
Churchwell
Mariann D
MD
Patel
Jignesh H
JH
DePestel
Daryl D
DD
Mueller
Bruce A
BA
D003198:Computer Simulation; D006440:Hemofiltration / Q000379:methods*; D006801:Humans; D008567:Membranes, Artificial; D006435:Renal Dialysis / Q000379:methods*; D017334:Teicoplanin / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000097:blood / Q000737:chemistry; D014508:Urea / Q000097:blood
D008567:Membranes, Artificial; D017334:Teicoplanin; C469289:dalbavancin; D014508:Urea