Abstract | BACKGROUND AND OBJECTIVE: Questions have been raised regarding nephrotoxicity from vancomycin. A few small studies have shown that higher trough concentrations of vancomycin result in more nephrotoxicity. The purpose of this study was to evaluate risk factors that may predispose patients to nephrotoxicity in those concomitantly receiving vancomycin. METHODS: RESULTS: Seventy-seven subjects were included in the nephrotoxic group and 149 were in the control group. The proportion of men in the nephrotoxic group was higher (68 vs. 50 %, p = 0.0135). Hypertension (74 vs. 51 %, p = 0.0009), diabetes (49 vs. 30 %, p = 0.0046), and furosemide use (65 vs. 39 %, p = 0.0009) were more common in the nephrotoxic group. The proportion of subjects with baseline CLCR ≤63.5 mL/min was higher in the nephrotoxic group. Furosemide use (odds ratio [OR] 2.91, 95 % CI 1.64-5.15), hypertension (OR 2.74, 95 % CI 1.5-5.0), and vancomycin trough concentration ≥16.2 μg/mL (OR 2.33, 95 % CI 1.25-4.44) were each associated with nephrotoxicity during vancomycin therapy. CONCLUSIONS: In summary, the patient profile exhibiting the greatest risk (OR 4.99) of developing kidney injury is one who has hypertension, is receiving furosemide therapy, and has vancomycin trough concentrations ≥16.2 μg/mL.
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Authors | Diane Cappelletty, Alyse Jablonski, Rose Jung |
Journal | Clinical drug investigation
(Clin Drug Investig)
Vol. 34
Issue 3
Pg. 189-93
(Mar 2014)
ISSN: 1179-1918 [Electronic] New Zealand |
PMID | 24385282
(Publication Type: Journal Article)
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Chemical References |
- Anti-Bacterial Agents
- Vancomycin
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Topics |
- Acute Kidney Injury
(chemically induced, diagnosis, epidemiology)
- Adult
- Aged
- Anti-Bacterial Agents
(adverse effects)
- Diabetes Mellitus
(diagnosis, epidemiology)
- Female
- Humans
- Hypertension
(diagnosis, epidemiology)
- Male
- Middle Aged
- Retrospective Studies
- Risk Factors
- Vancomycin
(adverse effects)
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