Association of the predicted free blood concentration of teicoplanin with the development of renal dysfunction
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Published on: March 11, 2016
Kyohei Sugiyama1, Keita Hirai2,3, Yukako Suyama4
1Department of Pharmacy, Shizuoka General Hospital, 4-27-1 Kita Ando Aoi-Ku, Shizuoka, 420-8527, Japan. kyohei-sugiyama@i.shizuoka-pho.jp.
Purpose:
In clinical practice, teicoplanin (TEIC) is typically administered at a trough concentration of 15-40 µg/mL. TEIC has a protein binding rate of approximately 90%, and its concentration rarely exceeds 40 µg/ml. Nevertheless, an increase in the free blood trough concentration may result in renal dysfunction. However, the relationship between the free blood trough concentration and the occurrence of renal dysfunction remains unclear. This study aimed to examine the impact of the predicted free blood concentration on the development of renal dysfunction.
Methods:
This retrospective study included patients who underwent TEIC and had at least one trough concentration measurement. The association between the frequency of renal dysfunction occurrence and the predicted free blood concentration was evaluated using the following equation: free TEIC concentration = total TEIC concentration/(1 + 1.78 × serum albumin level).
Results:
Of the 170 patients included in this study, 18% (31/170) developed renal dysfunction. The predicted free trough concentration was significantly higher in the renal dysfunction onset group than in the nononset group. However, the total trough concentration was not significantly associated with the development of renal dysfunction. The odds ratio for developing renal dysfunction was 4.5 (95% confidence interval, 1.9-10.5; P < 0.001) when the predicted free trough concentration was > 4.0 µg/mL.
Conclusion:
Elevated free trough concentrations of TEIC were associated with an increased risk of renal dysfunction. Controlling the increase in the predicted free blood concentration may effectively prevent the development of renal dysfunction.
Insights
Elevated free teicoplanin (TEIC) levels increase the risk of kidney damage. Monitoring and controlling free TEIC concentrations can help prevent renal dysfunction in patients.
Area of Science:
- Pharmacology
- Nephrology
- Clinical Pharmacy
Background:
- Teicoplanin (TEIC) is commonly used in clinical settings.
- TEIC exhibits high protein binding (around 90%).
- The relationship between free TEIC concentrations and renal dysfunction is not fully understood.
Purpose of the Study:
- To investigate the impact of predicted free teicoplanin blood concentration on the development of renal dysfunction.
- To clarify the association between free TEIC trough concentration and renal dysfunction incidence.
Main Methods:
- Retrospective study design.
- Inclusion of patients with TEIC treatment and trough concentration measurements.
- Calculation of predicted free TEIC concentration using the formula: total TEIC concentration / (1 + 1.78 × serum albumin level).
Main Results:
- 18% of patients (31/170) developed renal dysfunction.
- Significantly higher predicted free trough TEIC concentrations were observed in the renal dysfunction group.
- Total trough TEIC concentration was not significantly associated with renal dysfunction.
- An increased risk of renal dysfunction (OR 4.5) was noted when predicted free trough TEIC exceeded 4.0 µg/mL.
Conclusions:
- Elevated free teicoplanin trough concentrations are linked to a higher risk of renal dysfunction.
- Managing and controlling predicted free TEIC blood concentrations may be crucial for preventing renal dysfunction.
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