Metronidazole kinetics in patients with acute renal failure on dialysis: A cumulative study

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Abstract
Nine patients with acute renal failure who were undergoing dialysis at intervals depending on clinical state were injected with metronidazole, 7.5 mg/kg i.v. every 8 h. Plasma samples were drawn during the 8 h after the 1st infusion, during the 1st dialysis session and during the course of the 4th infusion after the first 3 dialysis sessions. Metronidazole and its 2 main metabolites (alcohol[M1] and acid [M2]) were assayed by high-pressure liquid chomatography. The plasma t1/2 [half-time] of metronidazole (6.8 h) is of the same order as that in healthy subjects. M1 and M2 plasma levels increased continuously until the next infusion. Dialysis clearances of metronidazole and its metabolites were .apprx. 60 ml/min; 25% of metronidazole in the body at the beginning of hemodialysis was eliminated. The corresponding apparent t1/2 are 3.3 h (metronidazole), 8.0 h (M1) and 7.9 h (M2). In patients with acute renal disease under hemodialysis, there was no cumulation of metronidazole and its metabolites; hence there is no need for change in dosage regimen.

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