Konishi K, Suzuki H, Saruta T, Hayashi M, Deguchi N, Tazaki H, Hisaka A
Department of Medicine, School of Medicine, Keio University, Tokyo, Japan.
Antimicrob Agents Chemother. 1991 Aug;35(8):1616-20. doi: 10.1128/AAC.35.8.1616.
The removal of imipenem and cilastatin by hemodialysis was studied in 14 (for imipenem) and 6 (for cilastatin) subjects. Following intravenous infusion of imipenem and cilastatin at a combined concentration of 10 mg/kg of body weight, drug levels in plasma were determined serially during off- and on-hemodialysis periods, which were 2 and 4 h, respectively. The biexponential decay of the drug levels in plasma was evident in each subject for both imipenem and cilastatin. Hemodialysis accelerated the elimination of both imipenem and cilastatin: the mean elimination-phase half-life of imipenem was shortened from 200 to 78 min, and that of cilastatin was shortened from 445 to 115 min. Hemodialysis clearance of imipenem and cilastatin was calculated by five different methods, each with intrinsic assumptions. The mean hemodialysis clearance of imipenem was estimated to be 74.08 +/- 13.29 ml/min, and that of cilastatin was estimated to be 65.0 +/- 8.6 ml/min, after consideration of various methodological limitations. It was estimated that in a hypothetical anephric patient weighing 60 kg, a 4-h hemodialysis treatment would remove 54.8% of the imipenem and 62.9% of the cilastatin present in the body at the start of dialysis.
在14名受试者（针对亚胺培南）和6名受试者（针对西司他丁）中研究了血液透析对亚胺培南和西司他丁的清除情况。以10mg/kg体重的联合浓度静脉输注亚胺培南和西司他丁后，分别在血液透析前2小时和透析期间4小时连续测定血浆中的药物水平。亚胺培南和西司他丁在每个受试者的血浆中均呈现双指数衰减。血液透析加速了亚胺培南和西司他丁的清除：亚胺培南的平均消除相半衰期从200分钟缩短至78分钟，西司他丁的平均消除相半衰期从445分钟缩短至115分钟。通过五种不同方法计算了亚胺培南和西司他丁的血液透析清除率，每种方法都有其内在假设。考虑到各种方法学限制后，亚胺培南的平均血液透析清除率估计为74.08±13.29ml/min，西司他丁的平均血液透析清除率估计为65.0±8.6ml/min。据估计，在一名假设体重60kg的无肾患者中，4小时的血液透析治疗将清除透析开始时体内54.8%的亚胺培南和62.9%的西司他丁。
