The target population of this study was Chinese septic patients with or without acute kidney injury, which were divided into five groups including group A of 12 patients (receiving meropenem) without acute kidney injury, group B of 12 patients (receiving meropenem) without renal replacement therapy for acute kidney injury, group C of 12 patients (receiving meropenem) with intermittent renal replacement therapy for acute kidney injury, group D of 4 patients (receiving meropenem) with continuous renal replacement therapy for acute kidney injury and group E of 4 patients (receiving piperacillin) with intermittent renal replacement therapy for acute kidney injury. All subjects who may participate in the study must sign informed consent form (if one has no capacity for civil conduct, the guardian will sign on behalf of him), and the subjects who sign informed consent form will be screened for eligibility evaluation based on the inclusion criteria. Waste blood samples (if any) obtained from blood biochemical or routine blood tests and urine (if any) were collected in all groups and residual urine volume within 24 hours was recorded. Subjects were treated with the regimens of meropenem or piperacillin on study day (D1), which were determined and implemented by the clinician according to the treatment guidelines. Medications that may affect OAT function were not allowed during the study period (evaluated and recorded by the clinician). Venous blood was collected from all subjects at 0 h predose; at 0 h, 0.5 h, 3.5 h (Q8h) or 5.5 h (Q12h) after the end of the infusion; and within 30 min before next dose. In addition to 4 mL of venous blood taken at 0 h predose, 1 mL of venous blood should be collected at every other time point. Meanwhile, information of drug combination, complications, drug susceptibility, pathogen detection, demographic data and RRT parameters (if any) were also recorded during the period of this study.
This study was a single-center, open clinical study in Chinese septic patients with or without acute kidney injury. The aims of this study were to obtain the blood concentration and pharmacokinetic parameters of meropenem and piperacillin, exosome information and endogenous biomarker, and to explore the functional changes of OATs under the condition of sepsis and acute kidney injury.