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Vancomycin Nephrotoxicity Causing Renal Transplant Acute Kidney Injury
Ngoentra Tantranont1, Sean Hebert2, Luan D Truong3
1Department of Pathology and Genomic Medicine, The Houston Methodist Hospital, Houston, Texas; Department of Pathology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Transplantation Proceedings
|November 3, 2021
Summary
Vancomycin nephrotoxicity (VN) can cause acute kidney injury (AKI) in kidney transplant patients. While exhibiting unique clinical patterns, VN diagnosis is confirmed by characteristic renal biopsy findings.
Area of Science:
- Nephrology
- Pharmacology
- Transplantation
Background:
- Vancomycin is frequently used but known to cause nephrotoxicity.
- Vancomycin nephrotoxicity (VN) is a recognized cause of acute kidney injury (AKI).
- VN's role in renal transplant recipients has been underemphasized.
Purpose of the Study:
- To report the first cases of AKI caused by VN in renal transplant recipients.
- To describe the clinical characteristics and diagnostic features of VN in this specific population.
Main Methods:
- Case series reporting three renal transplant recipients who developed AKI during vancomycin treatment.
- Clinical data review and analysis of renal transplant biopsy findings.
Main Results:
- AKI developed concurrently with vancomycin treatment and resolved upon its discontinuation in all three cases.
- VN in renal transplant recipients showed atypical features, including capricious onset and gradual progression, differing from the general population.
- Renal transplant biopsies consistently demonstrated characteristic features of VN, enabling definitive diagnosis.
Conclusions:
- Vancomycin nephrotoxicity is an unusual but documented cause of AKI in kidney transplant recipients.
- VN in transplant patients may present with atypical clinical behaviors but shows characteristic biopsy findings.
- Renal biopsy is crucial for diagnosing VN in the context of AKI in kidney transplant recipients.
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