人工腎臓の薬物除去能, cefazolinについて

Abstract

The pharmacodynamics of cefazolin were compared in 10 patients with chronic renal failure during hemodialysis, hemofiltration and peritoneal dialysis. The cefazolin concentrations in serum, dialysate and filtrate were determined by bioassay using bacillus subtilus ATCC 6633. One gram of cefazolin was given intravenously 10 minutes before the biginnig of procedure. The concentration of cefazolin in serum was 175.2 ±39.0 µg/ml at the biginnig of procedure. The half life of cefazolin was estimated from serum disappearance curve of cefazolin by means of pool model. They were 4.85 hours in hemodialysis patients, 4.77 hours in hemofiltration patients, 29.70 hours in 2 peritoneal dialysis patients and 19.58 hours in a peritoneal dialysis patient, respectively. Clearance rates for urea, creatinine and cefazolin were 139.4±23.7 ml/min, 109.3±28.6 ml/min and 23.9±4.3 ml/min in hemodialysis, 82.6±6.0ml/min, 83.7±8.1 ml/min and 11.2±3.8ml/min in hemofiltration and 18.9±3.0 ml/min, 13.4± 1.6 ml/min and 3.0±0.9 ml/min in peritoneal dialysis, respectively. Clearance for cefazolin was much lower than that for urea and creatinine in each procedure. This can be explained by the binding rate of cefazolin to serum protein and difference of mass transfer in each purification method.