Purpose. Drug dose recommendations are not well defined in patients undergoing continuous renal replacement therapy (CRRT)\ndue to limited published data. Several guidelines and pharmacokinetic equations have been proposed as tools forCRRT drug dosing.\nDose recommendations derived from these methods have yet to be compared or prospectively evaluated. Methods. A literature\nsearch of PubMed, Micromedex, and Embase was conducted for 40 drugs commonly used in the ICU to gather pharmacokinetic\ndata acquired from patients with acute and chronic kidney disease as well as healthy volunteers. These data and that obtained\nfrom drug package inserts were gathered for use in three published CRRT drug dosing equations. Doses calculated for a model\npatient using each method were compared to doses suggested in a commonly used dosing text. Results. Full pharmacokinetic data\nwas available for 18, 31, and 40 agents using acute kidney injury, end stage renal disease, and normal patient data, respectively.\nOn average, calculated doses differed by 30% or more from the doses recommended by the renal dosing text for >50% of the\nmedications. Conclusion.Wide variability in dose recommendations for patients undergoing CRRT exists when these equations are\nused. Alternate, validated dosing methods need to be developed for this at-risk patient population.
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