Does High Dose Haemodiafiltration alter drug kinetics compared to conventional dialysis therapy?

Principal Researcher – Kathrine Parker

Previous studies looking at changes of drug levels during dialysis are at least 20 years old which does not reflect the effects of newer more effective dialysis methods. We know that these newer dialysis methods remove more toxins and are so believe they are likely to remove more drugs. Drugs we are studying include the anti-epilepsy drug sodium valproate, the antibiotics flucloxacillin and meropenem and the pain relief drug gabapentin. If levels of sodium valproate drop dramatically during dialysis it may put the patient at risk of a seizure and suggest a ‘top up’ dose. Meropenem and flucloxacillin removal by dialysis might reduce the levels below what is needed to treat the infection putting the patient at risk of antibiotic resistance and ineffective treatment. We may find that patients require additional doses on dialysis days. Gabapentin is likely to be highly removed by dialysis and may require additional doses to prevent pain/restless legs or itching. The study has the potential to define the way drugs are handled by current dialysis techniques and its output could inform safer and adequate prescribing in dialysis patients.