Effective treatment of vancomycin nephrotoxicity with continuous venous-venous haemodiafiltration (CVVHDF) in a
Meng Lv1, Shuli Ma1, Nan Chen1
1Department of Pharmacy, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou, China.
What Is Known And Objective:
Vancomycin removal by dialysis uses methods that differ in type of dialysis membrane, dialysis fluxes and duration, ultrafiltration rate and Kt/Vurea (K = dialyser urea clearance, t = time on dialysis and V = total body water) in case of nephrotoxicity. We applied continuous venous-venous haemodiafiltration (CVVHDF) to treat a paediatric case of vancomycin nephrotoxicity caused by high serum trough concentrations.
Case Summary:
We report the case of a 4-year and 7-month-old boy with serum trough concentration of vancomycin of 86.0 mg/L after a 2-day treatment with vancomycin. His serum creatinine increased from 13.3 μmol/L at baseline to 227.0 μmol/L. We discontinued vancomycin and performed a 22-hours CVVHDF with high-flux membrane. Vancomycin decreased by 69.4% (82.1-25.1 mg/L), and renal function improved.
What Is New And Conclusion:
Therapeutic drug monitoring and laboratory indicator measurements should be performed early during vancomycin treatment in paediatric patients with nephrotoxicity risk factors. Vancomycin removal by CVVHDF can be effective in paediatric acute kidney injury (AKI) associated with vancomycin-associated nephrotoxicity (VAN).
More Related Videos
05:23Continuous Manual Exchange Transfusion for Patients with Sickle Cell Disease: An Efficient Method to Avoid Iron Overload
Published on: March 14, 2017
07:59Bedside Ultrasound for Guiding Fluid Removal in Patients with Pulmonary Edema: The Reverse-FALLS Protocol
Published on: July 28, 2018
Related Concept Videos
Extracorporeal Removal of Drugs: Continuous Renal Replacement Therapy
Continuous Renal Replacement Therapy
Pharmacokinetics in Pediatric Patients: Drug Excretion
Drug Accumulation During Multiple Dosing: Intermittent IV Infusions
Acute Kidney Injury V: Interprofessional Care
Extracorporeal Removal of Drugs: Hemoperfusion and Hemofiltration
