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Article

A Pharmacokinetic Study Comparing the Clearance of Vancomycin during Haemodialysis Using Medium Cut-Off Membrane (Theranova) and High-Flux Membranes (Revaclear)

Hastings Hospital, Hawkes Bay District Health Board, Hastings 4120, New Zealand
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Received: 30 March 2020 / Revised: 30 April 2020 / Accepted: 6 May 2020 / Published: 12 May 2020
(This article belongs to the Special Issue Immune Dysfunction in Uremia)
Medium cut-off membrane (MCO) dialysers have been shown to remove a range of middle molecules, which are associated with adverse outcomes in haemodialysis (HD) patients, more effectively than high-flux HD. Vancomycin is widely used in HD patients for treating a variety of infections. To avoid subtherapeutic trough concentrations, it is important to understand vancomycin clearance in patients undergoing HD with the MCO membrane. This open label single centre, cross-over clinical study compared the vancomycin pharmacokinetics in chronic HD patients using MCO membrane (Theranova) and high-flux membrane (Revaclear). Five patients established on chronic HD who were due to receive vancomycin were enrolled. The study used alternating Theranova and Revaclear dialysis membranes over six consecutive sessions. Vancomycin was administered over the last one to two hours of each HD session. The maintenance dose was adjusted based on pre-HD serum concentrations. Over the 210 study samples, vancomycin clearance was higher with MCO-HD compared to high-flux HD but not statistically significant. Median percentage of vancomycin removal at 120 min by MCO membrane was 39% (20.6–51.5%) compared with 34.1% (21.3–48.4%) with high-flux HD. MCO-HD removes a slightly higher percentage of vancomycin at 120 min into dialysis compared to high-flux membrane dialysis in HD patients with infections. Application of vancomycin during the last one to two hours of each dialysis is required to maintain therapeutic concentrations to minimise loss through the dialyser and maintain therapeutic levels. View Full-Text
Keywords: haemodialysis; high-flux; Revaclear; Theranova; medium cut-off; vancomycin haemodialysis; high-flux; Revaclear; Theranova; medium cut-off; vancomycin
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MDPI and ACS Style

Allawati, H.; Dallas, L.; Nair, S.; Palmer, J.; Thaikandy, S.; Hutchison, C. A Pharmacokinetic Study Comparing the Clearance of Vancomycin during Haemodialysis Using Medium Cut-Off Membrane (Theranova) and High-Flux Membranes (Revaclear). Toxins 2020, 12, 317. https://0-doi-org.brum.beds.ac.uk/10.3390/toxins12050317

AMA Style

Allawati H, Dallas L, Nair S, Palmer J, Thaikandy S, Hutchison C. A Pharmacokinetic Study Comparing the Clearance of Vancomycin during Haemodialysis Using Medium Cut-Off Membrane (Theranova) and High-Flux Membranes (Revaclear). Toxins. 2020; 12(5):317. https://0-doi-org.brum.beds.ac.uk/10.3390/toxins12050317

Chicago/Turabian Style

Allawati, Hussain, Linda Dallas, Sreejith Nair, Janine Palmer, Shaiju Thaikandy, and Colin Hutchison. 2020. "A Pharmacokinetic Study Comparing the Clearance of Vancomycin during Haemodialysis Using Medium Cut-Off Membrane (Theranova) and High-Flux Membranes (Revaclear)" Toxins 12, no. 5: 317. https://0-doi-org.brum.beds.ac.uk/10.3390/toxins12050317

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