Changes of the serum amikacin (AMK) level in patients with serious acute renal failure treated by continuous arteriovenous hemofiltration (CAVH).

This study clarified changes in the serum amikacin (AMK) levels in the blood of 5 patients (4 men and 1 woman; average age 59.2 +/- 5.9 years) with serious acute renal failure treated by continuous arteriovenous hemofiltration (CAVH). The following principal results were obtained. (A) The average remaining rate of AMK in the blood after 6 h was 60.8 +/- 5.3% and 50.4 +/- 5.3% after 12 h. The average half-life period (t1/2 beta) of AMK in the blood during CAVH was 18.3 +/- 3.4 h. (B) The remaining rate of AMK in the blood after 12 h correlated significantly with the blood urea nitrogen (BUN) level (r = 0.71, p less than 0.05) and with the volume of urine excreted per day (r = -0.71, p less than 0.05). (C) The average lowest AMK concentration after 24 h for a continuous 17-day period was 3.3 micrograms/ml. These results suggest that the administration of 100 mg of AMK once a day is useful and safe for patients with serious acute renal failure treated by CAVH and that it will not accumulate in the body.