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Relationship between vancomycin-associated nephrotoxicity and the number of combined nephrotoxic agents

T Ueki1, E Sanematsu2, Y Furuya2

  • 1Department of Hospital Pharmacy, Hospital of the University of Occupational and Environmental Health, Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, Japan; Department of Pharmacy, Kitakyushu Municipal Medical Center, Sojo University, Japan; Department of Pharmacy Practice, Graduate School of Biomedical Sciences, Nagasaki University, Sojo University, Japan;,

Die Pharmazie
|June 17, 2020
PubMed

Insights

High vancomycin trough concentrations and the number of combined nephrotoxic agents are significant risk factors for vancomycin-induced kidney damage. This study clarifies the impact of multiple nephrotoxic agents on vancomycin nephrotoxicity incidence.

Area of Science:

  • Pharmacology
  • Nephrology
  • Clinical Medicine

Background:

  • Vancomycin is a critical antibiotic for treating serious Gram-positive infections.
  • Vancomycin is known to cause nephrotoxicity, but the role of concurrent nephrotoxic agents is not fully understood.

Purpose of the Study:

  • To investigate the factors contributing to vancomycin-induced nephrotoxicity.
  • To determine the influence of the number of combined nephrotoxic agents on vancomycin nephrotoxicity.

Main Methods:

  • Retrospective analysis of 148 inpatients treated with vancomycin.
  • Patients were categorized into nephrotoxicity and non-nephrotoxicity groups.
  • Multiple logistic regression analysis was performed on key patient background factors.

Main Results:

  • Significant differences were observed in weight, baseline serum creatinine changes, BUN/creatinine ratio, vancomycin therapy duration, vancomycin trough concentration, and number of combined nephrotoxic agents between groups.
  • Highest vancomycin trough concentration (OR 1.080, p=0.003) and increased number of combined nephrotoxic agents (OR 1.590, p=0.010) were significantly associated with nephrotoxicity.

Conclusions:

  • Elevated vancomycin trough concentrations are a key risk factor for nephrotoxicity.
  • The number of co-administered nephrotoxic agents significantly increases the risk of vancomycin-induced kidney injury.

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