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Medientyp:
E-Artikel
Titel:
Differences in drug removal between standard high-flux and medium cut-off dialyzers in a case of severe vancomycin toxicity
Beteiligte:
Aberger, Simon;
Kolland, Michael;
Eller, Kathrin;
Rosenkranz, Alexander R;
Kirsch, Alexander H
Erschienen:
Oxford University Press (OUP), 2024
Erschienen in:Clinical Kidney Journal
Sprache:
Englisch
DOI:
10.1093/ckj/sfae063
ISSN:
2048-8513;
2048-8505
Entstehung:
Anmerkungen:
Beschreibung:
<jats:title>ABSTRACT</jats:title>
<jats:p>Vancomycin is a widely used glycopeptide antibiotic with the need for therapeutic drug monitoring to avoid renal toxicity. We report a case of severe vancomycin-associated anuric acute kidney injury managed with successful drug-removal by hemodialysis (HD) using different types of dialyzers. Medium cut-off (MCO) and high-flux dialyzers were effective in drug removal. Higher vancomycin elimination rate and lower plasma half-life were achieved with MCO dialyzer despite low-flow vascular access and intolerance to ultrafiltration. MCO dialyzers may be reasonable for drug removal in patients with intolerance of ultrafiltration, low-flow vascular access or impracticality of hemodiafiltration. Future studies should explore the use of MCO dialyzers in comparison with high-flux HD and hemodiafiltration in both the acute and chronic setting.</jats:p>