PMC7303306_01
(A) Ganciclovir plasma concentration measured (black dots: pre-filter, gray dots: post-filter) and model-predicted individual concentration-time profile since last normal (for renal function adjusted) ganciclovir dose (black line: pre-filter and intra-dialytic plasma concentration, dashed line: post-filter concentration assuming a constant extraction ratio within each hemodiafiltration session). ^: time and dose of i.v. ganciclovir administered. Gray bars indicate time on hemodiafiltration. (B) Urea concentration measured (dots) and model-predicted urea concentration-time profile. Open circles: (pre-filter) concentrations below limit of quantification (LOQ) (0.1 for ganciclovir, 0.5 mmol/L for urea), plotted at LOQ/2. (C) model-predicted amount of ganciclovir in the body (black solid line), and predicted total amount eliminated since start of first HDF session (dashed line), which is the sum of elimination by residual ganciclovir clearance of the patient (yellow shaded area, limited by dotted line) and HDF (red shaded area).
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Based on individual distribution and clearance parameters, the amount of ganciclovir in the body prior to the first HDF session was predicted to be 380 mg, which was reduced by 288 mg (76%) during the first HDF session. 269 mg (93%) were predicted to be eliminated by HDF (=Aremoved,HDF and fremoved,HDF) and 19 mg (7%) by patient's residual clearance (Figure 1C). All model predictions are shown in Figure 1.