Impact of Continuous Renal Replacement Therapy with Polyacrylonitrile-Derived Filter on Caspofungin Concentration: A Retrospective Study
Romain Arrestier, Claire Pressiat, Laura Bouabdallah, Paul Masi, Nicolas Mongardon, Anne Hulin, Armand Mekontso Dessap, Keyvan Razazi
Abstract
INTRODUCTION: Caspofungin pharmacokinetics may be altered in critically ill patients. In vitro studies suggest significant drug adsorption with polyacrylonitrile (PAN) membranes during continuous renal replacement therapy (CRRT). METHODS: ) from 35 ICU patients between 2021 and 2024, comparing those on PAN-CRRT (n = 19) versus those without (n = 47). RESULTS: at 12 h was similar between groups, but at 18 and 24 h, it was significantly higher in the PAN-CRRT group [5.3 (4.1-6.9) vs. 3.3 (1.9-3.7) mg/L, p = 0.04 and 5.3 (3.9-5.8) vs. 3.1 (2.5-4.5) mg/L, p = 0.01, respectively]. ECMO use was more frequent in PAN-CRRT patients (75% vs. 21.7%, p = 0.01). Persistent candidemia occurred in three patients (one in PAN-CRRT, two in non-PAN-CRRT). CONCLUSION: This study found no evidence of caspofungin depletion with PAN-CRRT, warranting further research on clinical outcomes.