The Glomerular Filtration Rate Estimators in the Pharmacokinetic Modelling in Acute Kidney Injury: An Observational Study
| Autor: | Vaidotas Galaune, Astra Vitkauskiene, Silvijus Abramavicius, Romaldas Mačiulaitis, Gintautas Gumbrevičius, Agile Tunaityte, Aurelija Radzeviciene |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Microbiology (medical)
medicine.medical_specialty Population 030232 urology & nephrology Urology Renal function 030204 cardiovascular system & hematology urologic and male genital diseases Biochemistry Microbiology Article 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Pharmacokinetics creatinine clearance medicine Pharmacology (medical) Dosing General Pharmacology Toxicology and Pharmaceutics education reproductive and urinary physiology Creatinine education.field_of_study glomerular filtration rate estimation business.industry urogenital system lcsh:RM1-950 Acute kidney injury medicine.disease female genital diseases and pregnancy complications Infectious Diseases lcsh:Therapeutics. Pharmacology Drug development chemistry acute kidney injury business Kidney disease |
| Zdroj: | Antibiotics Volume 10 Issue 2 Antibiotics, Vol 10, Iss 158, p 158 (2021) |
| ISSN: | 2079-6382 |
| Popis: | The glomerular filtration rate (GFR), according to which the drug dose for patients with chronic kidney disease (CKD) is adjusted, is computed with estimators (eGFR) that are developed specifically for CKD. These particular types of estimators are also used in population pharmacokinetic (pop PK) modelling in drug development. Similar approaches without scientific validation have been proposed for patients with acute kidney injury (AKI), yet it is uncertain which specific eGFR should be used for drug dosing or in pop PK models in patients with AKI. In our study, we included 34 patients with AKI and vancomycin (VCM) treatment, and we built both individual PK and pop PK (non-linear mixed-effects, one-compartment) models to see which eGFR estimator is the best covariate. In these models different eGFRs (Cockcroft-Gault, MDRD, CKD-EPI 2009, Jelliffe and Jelliffe, Chen et al., and Yashiro et al. 2013) were used. We included six additional patients to validate the final pop PK model. All eGFRs underrate the true renal clearance in the AKI, so we created pop PK models for VCM dosing in AKI with all eGFRs, to discover that the most accurate model was the one with the Cockcroft-Gault estimator. Since the eGFRs underestimate the true renal clearance in AKI, they are inaccurate for clinical drug dosing decisions, with the exception of the Cockcroft-Gault one, which is appropriate for the pop PK models intended for drug development purposes in AKI. |
| Databáze: | OpenAIRE |
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