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Elimination of fluconazole during continuous renal replacement therapy. An in vitro assessment

Abstract : Continuous renal replacement therapy (CRRT) efficiently eliminates fluconazole. However, the routes of elimination were not clarified. Adsorption of fluconazole by filters is a pending question. We studied the elimination of fluconazole in a model mimicking a session of CRRT in humans using the NeckEpur ® model. Two filters were studied. The AV1000 ® -polysulfone filter with the Multifiltrate Pro. Fresenius and the ST150 ® -polyacrylonitrile filter with the Prismaflex. Baxter-Gambro were studied. Continuous filtration used a flowrate of 2.5 L/h in post-dilution only. Session were made in duplicate. Routes of elimination were assessed using the NeckEpur ® model. The mean measured initial fluconazole concentration (mean ± SD) for the four sessions in the central compartment (CC) was 14.9 ± 0.2 mg/L. The amount eliminated from the CC at the end of 6 h-session at a 2.5 L/h filtration flowrate for the AV1000 ® -polysulfone and the ST150 ® -polyacrylonitrile filters were 90%–93% and 96%–94%, respectively; the clearances from the central compartment (CC) were 2.5–2.6 and 2.4–2.3 L/h, respectively. The means of the instantaneous sieving coefficient were 0.94%–0.91% and 0.99%–0.91%, respectively. The percentages of the amount eliminated from the CC by filtration/adsorption were 100/0%–95/5% and 100/0%–100/0%, respectively. Neither the ST150 ® -polyacrylonitrile nor the AV1000 ® -polysulfone filters result in any significant adsorption of fluconazole.
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https://hal.inrae.fr/hal-03339579
Contributor : Roselyne Tâche <>
Submitted on : Thursday, September 9, 2021 - 3:24:49 PM
Last modification on : Monday, September 20, 2021 - 4:19:35 PM

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Frédéric Baud, Vincent Jullien, Tarik Abarou, Benoît Pilmis, Jean-Herlé Raphalen, et al.. Elimination of fluconazole during continuous renal replacement therapy. An in vitro assessment. International Journal of Artificial Organs, Wichtig Editore, 2021, 44 (7), pp.453-464. ⟨10.1177/0391398820976144⟩. ⟨hal-03339579⟩

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