Gentamicin disposition in children with chronic renal failure.
Gentamicin (G) disposition in six children with stable chronic renal failure (CRF) and in nine children with normal renal function (NRF) was determined by pharmacokinetic analysis of serum G concentration versus time data obtained over an 8-hour period following the administration of an intravenous loading dose. ES-TRIP curve fitting indicated that G disposition was best described by a biexponential function; however, a one-compartment open model also suitably characterized G disposition for an 8-hour period. Peak serum G concentrations were similar between the CRF and NRF groups, but concentrations were significantly different (P less than 0.005) at 8 hours following the loading dose. Also, significant differences (P less than 0.001) were found between the two groups for beta, t1/2 beta, plasma clearance, and k10. The relationship of creatinine clearance (Clcr) versus beta, described by the equation beta = 0.033 + 0.003 X Clcr (P less than 0.005, r = 0.97) permitted the best prediction of the G elimination constant from a parameter of renal function. This relationship remained linear over a broad range of Clcr values in our patients and in other previously reported children with CRF and NRF.