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Pharmacokinetics of gentamicin in hemodialysis patients: a comparative study between diabetic and non-diabetic patients

  • Nephrology - Original Paper
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Abstract

Diabetic nephropathy is one of the leading causes of end-stage renal disease (ESRD). There is some evidence that differences in extracellular fluid volume and capillary permeability do exist between diabetic and non-diabetic patients. This may have an impact on the gentamicin volume of distribution and clearance and thus dosing regimen. The pharmacokinetic parameters of gentamicin [volume of distribution (Vd), clearance (CL), elimination rate constant (K), and half life of elimination (t½)] were studied before hemodialysis in 20 non-diabetic patients (controls) and 20 diabetic patients, in addition to its hemodialysis clearance.

There were no statistically significant differences in Vd, CL, K, and t½ of gentamicin between the control and diabetic group. Therefore, a composite Vd of 0.25 l/kg and clearance of 0.063 ml/min/kg are suggested for dose calculation for both groups of patients. The mean hemodialysis clearance of gentamicin was higher in the diabetic (87.3 ml/min) than the control group (68.5 ml/min), comparing means by the unpaired t-test (P = 0.018).

In conclusion, the same method can be used to calculate the loading dose of gentamicin in ESRD patients between dialysis sessions in both controls and diabetics, whereas, diabetics are expected to receive a higher replacement dose after the end of dialysis.

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Acknowledgment

This research was supported by grant LGP-9-40 from King Abdulaziz City for Science and Technology, General Directorate of Research Grant Programs, Riyadh, Saudi Arabia. The expert technical assistance of Mr. Riyadh Alessa is greatly appreciated. The authors extend their thanks to the nursing staff at Asir Kidney Unit for facilitation of the research.

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Author notes

  1. Yacoub M. Irshaid

    Present address: Department of Pharmacology, Faculty of Medicine, University of Jordan, Amman, 11942, Jordan

Authors and Affiliations

  1. Department of Internal Medicine, College of Medicine, King Khalid University, P.O. Box 641, Abha, Saudi Arabia

    Mohammed A. Al-Homrany, Assem K. El Sherif & Haider A. Omar

  2. Department of Clinical Pharmacology, College of Medicine, King Khalid University, P.O. Box 641, Abha, Saudi Arabia

    Yacoub M. Irshaid

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  1. Mohammed A. Al-Homrany
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  2. Yacoub M. Irshaid
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Correspondence to Mohammed A. Al-Homrany.

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Supported by KACST grant LGP-9-40.

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Al-Homrany, M.A., Irshaid, Y.M., El Sherif, A.K. et al. Pharmacokinetics of gentamicin in hemodialysis patients: a comparative study between diabetic and non-diabetic patients. Int Urol Nephrol 41, 663–669 (2009). https://doi.org/10.1007/s11255-008-9456-2

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