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Rapid removal of vancomycin by continuous veno-venous hemofiltration.

Abstract
We describe a 14-year-old girl with staphylococcal (coagulase-negative) ventriculo-peritoneal shunt infection, who developed oliguric acute renal failure and was found to have a serum vancomycin concentration of 250 microg/ml. Since only about 10%-50% of vancomycin is bound to protein in blood, we employed continuous veno-venous hemofiltration (CVVH) with a high ultrafiltration rate (1,800 ml/h) for increased convective clearance to remove vancomycin, which may have contributed to the acute renal failure. At the end of 38 h of CVVH, the vancomycin concentration had decreased in an exponential manner to 27 microg/ml. Over the subsequent 3-4 days, her renal function improved and the vancomycin concentration decreased further to <5 microg/ml. In conclusion, we believe that a high serum vancomycin concentration may be nephrotoxic and demonstrate that CVVH can be used effectively to remove vancomycin in children with acute renal failure.
AuthorsM Shah, R Quigley
JournalPediatric nephrology (Berlin, Germany) (Pediatr Nephrol) Vol. 14 Issue 10-11 Pg. 912-5 (Sep 2000) ISSN: 0931-041X [Print] Germany
PMID10975298 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Anti-Bacterial Agents
  • Vancomycin
Topics
  • Acute Kidney Injury (chemically induced, therapy)
  • Adolescent
  • Anti-Bacterial Agents (adverse effects, blood, therapeutic use)
  • Female
  • Hemofiltration (methods)
  • Humans
  • Staphylococcal Infections (drug therapy, etiology)
  • Vancomycin (adverse effects, blood, therapeutic use)
  • Ventriculoperitoneal Shunt (adverse effects)

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