Dosing Guidelines for Patients Requiring Renal Replacement Therapy

Drug Dosing Guidelines for Patients Requiring Renal Replacement Therapy 

Drug doses need to be increased or supplemented for patients requiring renal replacement therapy only if CLec/ representing extracorporeal clearance from either intermittent hemodialysis or continuous renal replacement therapy/ is substantial when compared to CLr + CLjVR (Equation 6.12). Levy (34) has proposed that supplementation is needed only when CLec is greater than 30% of CL + CLjvr- Several approaches will be considered that can be used to make appropriate drug dose adjustments for patients requiring renal replacement therapy. 

A second approach is to calculate supplemental doses to replace drug lost during hemodialysis or continuous renal replacement therapy by directly measuring drug loss by extracorporeal removal or by 

A third approach is to use the principles discussed previously to calculate a maintenance dose multiplication factor (MDMF) that can be used to augment the dose that would be appropriate in the absence of renal replacement therapy (32). For continuous renal replacement therapy, MDMF is given simply by the following ratio of clearances  

The relative time on (toN) and off (toFF) extracorporeal therapy during a dosing interval also must be taken into account for conventional hemodialysis and other intermittent interventions. In this situation  

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