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The influence of vancomycin on renal functions, the predictors and associated factors for nephrotoxicity
Waleed M Altowayan1, Mugahid A Mobark1,2, Abdulmajed ALharbi3
1Department of Pharmacy Practice, College of Pharmacy, Qassim University, Buraydah, Saudi Arabia.
Background:
Vancomycin has been widely used in the last six decades to treat methicillin-resistant S. aureus (MRSA) and other resistant gram-positive infections. The risk of vancomycin toxicity increases with the utilization of higher doses while treating the resistant form of bacterial infections. Nephrotoxicity is one of the major complications reported to be a hinderance in the prognosis of vancomycin therapy.
Objectives:
This hospital-based study aimed to highlight the influence of vancomycin on renal function with special emphasis on identifying the predictors and augmenting factors for nephrotoxicity.
Methodology:
A cross-sectional, unicentric, hospital-based study was conducted at King Fahad Specialist Hospital (KFSH) in Qassim region in Saudi Arabia (KSA). It included 319 hospitalized patients who received vancomycin at intermittent doses (15 to 30 mg/kg IV per day) based on the diseased state. Data regarding vancomycin dose, frequency, duration and data of renal function tests and type of admission were analysed to evaluate their influence on the renal function using parameters such as blood urea, serum creatinine levels and creatinine clearance. One-way ANOVA and Spearman correlation test were used in the analysis of data.
Results:
Both male and female patients treated with vancomycin had significantly (p<0.05) elevated blood urea and serum creatinine levels compared to baseline levels while creatinine clearance was non-significantly varied. Increasing age, increasing body weight, higher vancomycin dose and trough levels, increased vancomycin frequency and duration, critically ill patients and site of infection were factors associated with significant (p<0.05) increases in blood urea and serum creatinine levels with reduction in creatinine clearance.
Conclusion:
Data suggested that vancomycin treatment reduced the renal function in patients and indicated its association with several predictors and confounding factors. The findings of the study might assist in identifying the patients under risk from the vancomycin-induced nephrotoxicity and in designing the preventive strategies to reduce such complications.
Insights
Vancomycin treatment can negatively impact kidney function, increasing blood urea and serum creatinine. Factors like higher doses, longer duration, and patient condition predict this vancomycin-induced nephrotoxicity.
Area of Science:
- Pharmacology and Nephrology
- Infectious Diseases
- Clinical Medicine
Background:
- Vancomycin is a critical antibiotic for treating methicillin-resistant Staphylococcus aureus (MRSA) and other resistant gram-positive infections.
- Higher vancomycin doses, often necessary for resistant infections, elevate the risk of toxicity, particularly nephrotoxicity, which can impede treatment success.
Purpose of the Study:
- To investigate the impact of vancomycin on renal function in hospitalized patients.
- To identify predictors and augmenting factors associated with vancomycin-induced nephrotoxicity.
Main Methods:
- A cross-sectional, hospital-based study involving 319 patients receiving vancomycin at King Fahad Specialist Hospital, Saudi Arabia.
- Analysis of vancomycin dosage, frequency, duration, and renal function tests (blood urea, serum creatinine, creatinine clearance).
- Statistical analysis using One-way ANOVA and Spearman correlation.
Main Results:
- Vancomycin treatment led to significant increases in blood urea and serum creatinine levels compared to baseline.
- Creatinine clearance showed non-significant variation.
- Predictors of increased nephrotoxicity included older age, higher body weight, increased vancomycin dose and trough levels, more frequent and prolonged administration, critical illness, and infection site.
Conclusions:
- Vancomycin therapy is associated with reduced renal function, with identified predictors and confounding factors.
- Findings can aid in identifying at-risk patients and developing strategies to prevent vancomycin-induced nephrotoxicity.
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