Abstract: FR-PO489
The Comparison of Vancomycin Removal Between Medium Cut-Off (Theranova®) and Other Dialyzers
Session Information
- Hemodialysis and Frequent Dialysis - IV
November 08, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 701 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Kim, Haksoo, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea (the Republic of)
- Park, Keun-hoi, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea (the Republic of)
- Yoon, Jung a, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea (the Republic of)
- Lee, Eun kyoung, Dankook University College of Medicine, Cheonan-si, Korea (the Republic of)
- Chang, Jai won, Dankook University College of Medicine, Cheonan-si, Korea (the Republic of)
Background
For more perfect treatment of Staphylococcus aureus infection in patients with end-stage renal disease (ESRD) on hemodialysis (HD), the maintenance of the target level of vancomycin (molecular weight 1,448 Dalton), 15~20 mg/L, is very important. Recently developed medium cut-off dialyzer, Theranova®, revealed superior clearance of waste product with large middle molecular weight (~ 45,000 Dalton). Hence, Theranova® may cause the suboptimal level of vancomycin in HD patients. The aim of this study is to investigate whether the reduction ratio of vancomycin (RRoV) in HD patients on Theranova® is greater than that on low-flux/high-flux dialyzer.
Methods
We analyzed prospectively collected vancomycin levels between April 2018 and April 2019. HD dialyzer was randomly assigned to the patients underwent intravenous vancomycin. In the first study (n=31, M:F=21:10, age 66 (55~73) years, dry body weight (DBW) 55.0 (50.8~63.5) Kg), RRoV by Theranova® was compared with that by low-flux dialyzers (FX 10®, Fresinius or Polyflux 17L®, Baxter). In the second study (n=24, M:F=15:9, age 63 (46~75) years, DBW 52.0 (46.0~63.0) Kg), RRoV by Theranova® was compared with that by high-flux dialyzers (FX 80®, Fresinius or Polyflux 170H®, Baxter).
Results
In two studies, there were no significant differences in the total amount of vancomycin, dosing interval, the level of vancomycin just before HD, the time of HD session, and the net ultrafiltration between two groups, respectively. The RRoV by Theranova® was greater than that by low-flux (45.5 (36.4~51.2) % vs. 33.3 (28.8~41.7) %, p=0.001). However, there was no significant difference in RRoV between Theranova® and how-flux dialyzer (50.6 (41.4~54.5) % vs. 46.4 (40.5~55.1) %, p=0.597).
Conclusion
Although the RRoV by Theranova® was significantly greater than that of low-flux dialyzer, there was no significant difference between Theranova® and high-flux dialyzer. Therefore, existing vancomycin dosing protocol on high-flux dialyzer could be valid in treatment of Staphylococcus aureus infection in patients with ESRD on HD using Theranova®, too.