Intradialytic Drug Removal by Short-daily Hemodialysis

This study has been completed.
Sponsor:
Information provided by:
Indiana University
ClinicalTrials.gov Identifier:
NCT00596167
First received: January 7, 2008
Last updated: October 12, 2011
Last verified: October 2011

January 7, 2008
October 12, 2011
September 2007
April 2009   (final data collection date for primary outcome measure)
Serum levels of levofloxacin, gentamicin and vancomycin in patients receiving short-daily hemodialysis [ Time Frame: Serum levels of the three tested antibiotics will be measured before, during and at periodic intervals after a short-daily hemodialysis session ] [ Designated as safety issue: No ]
Same as current
Complete list of historical versions of study NCT00596167 on ClinicalTrials.gov Archive Site
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Intradialytic Drug Removal by Short-daily Hemodialysis
Intradialytic Drug Removal by Short-daily Hemodialysis

Short-daily hemodialysis is increasingly becoming a preferred alternative to the conventional intermittent (three times per week) hemodialysis schedule. Studies have shown that short-daily dialysis improves a patient's quality of life, high blood pressure, anemia and calcium-phosphorus balance. Infection, however, will likely remain a persistent problem for dialysis patients regardless of the frequency of treatments. There is currently a wealth of information to guide doctors on how much and how frequently to give an antibiotic for patients who receive intermittent (thrice weekly) hemodialysis. However, there is very little information on how to prescribe antibiotics for patient's receiving short-daily hemodialysis. This study will develop drug dose guidelines for patients receiving short-daily hemodialysis for three frequently used antibiotics, vancomycin, levofloxacin and gentamicin. These guidelines will assist doctors so that patients receive the most effective dose and frequency of an antibiotic to treat their infection.

The following is the study hypothesis which will be tested with two-sided, one sample t-tests comparing the AUC observed to historical measures8.

1) Vancomycin, levofloxacin and gentamicin are removed to a greater extent by short-daily hemodialysis than intermittent hemodialysis.

The following are the specific aims:

  1. Determine the interdialytic pharmacokinetics of vancomycin, gentamicin, and levofloxacin by short-daily HD.
  2. Determine the extent of vancomycin removal when administered during the last hour of short-daily HD.
  3. Develop drug-dosing guidelines for vancomycin, gentamicin and levofloxacin for patients receiving short-daily HD.
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Interventional
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Endpoint Classification: Pharmacokinetics Study
Intervention Model: Single Group Assignment
Masking: Open Label
  • End Stage Renal Disease
  • Infection
Drug: Intravenous levofloxacin, gentamicin, vancomycin
Each subject will receive a single dose of 15 mg/kg vancomycin; 2 mg/kg gentamicin and 250 mg levofloxacin administered intravenously over a one-hour infusion period through the venous limb of their HD access (or tunneled catheter) via an IV pump.
Experimental: I
This study will have only one arm. This will be the experimental arm receiving the intravenous antibiotics, levofloxacin, vancomycin and gentamicin.
Intervention: Drug: Intravenous levofloxacin, gentamicin, vancomycin
Decker BS, Kays MB, Chambers M, Kraus MA, Moe SM, Sowinski KM. Vancomycin pharmacokinetics and pharmacodynamics during short daily hemodialysis. Clin J Am Soc Nephrol. 2010 Nov;5(11):1981-7. Epub 2010 Jul 8.

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Completed
10
September 2009
April 2009   (final data collection date for primary outcome measure)

Inclusion Criteria:

  • > 18 years old
  • currently receiving short-daily HD six times per week
  • have no other acute intercurrent illness

Exclusion Criteria:

  • history of a vancomycin, gentamicin or levofloxacin allergy
  • weight within ± 30% of their ideal body weight
  • Hgb < 10 mg/dl
Both
18 Years and older
No
Contact information is only displayed when the study is recruiting subjects
United States
 
NCT00596167
0609-18
Yes
Brian Scott Decker, Indiana University School of Medicine
Indiana University School of Medicine
Not Provided
Principal Investigator: Brian S Decker, MD, PharmD Indiana University School of Medicine
Indiana University
October 2011

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP