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Updated: Jun 12, 2025
A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion
Published on: February 2, 2021
Identification of factors associated with vancomycin-induced acute kidney injury: A retrospective analysis using the
Objective:
Previous findings on predictors of vancomycin-induced acute kidney injury (AKI) are inconsistent. We aimed to identify the predictors of vancomycin-induced AKI using the Observational Medical Outcome Partnership Common Data Model.
Materials And Methods:
We analyzed data from patients treated with vancomycin between January 1, 2012, and May 31, 2022, who were positive for Staphylococcus aureus and had undergone oxacillin susceptibility tests. After excluding patients without data for vancomycin or baseline serum creatinine levels, 116 patients were included in the final dataset. Data up to the third measured vancomycin concentration were collected for each patient. Logistic regression models were used to estimate the odds ratio and 95% confidence interval for each variable associated with vancomycin-induced AKI.
Results:
High baseline serum creatinine levels, intensive care unit admission, and concurrent renal disorders were significantly associated with vancomycin-induced AKI. Although high trough levels or area under the curve values were not significantly associated with vancomycin-induced AKI, both were significantly higher in patients with AKI than in those without AKI at the second vancomycin concentration measurement. The proportion with trough levels > 20 mg/L was higher in patients with AKI than in those without AKI at the third measurement.
Conclusion:
Our findings revealed that underlying renal disease and intensive care unit admission are more significantly associated with vancomycin-induced AKI than vancomycin pharmacokinetic parameters or dosage, likely due to vancomycin concentration-based dosage adjustment in clinical settings. Our findings may help develop strategies for reducing the incidence of vancomycin-induced AKI; however, further prospective studies are essential.
Insights
Underlying renal disease and ICU admission, not vancomycin levels, predict vancomycin-induced acute kidney injury (AKI). This study used real-world data to identify key risk factors for AKI in patients receiving vancomycin.
Area of Science:
- Pharmacology
- Nephrology
- Clinical Informatics
Background:
- Vancomycin is a critical antibiotic for treating Gram-positive infections.
- Predictors of vancomycin-induced acute kidney injury (AKI) remain inconsistent in existing literature.
- The Observational Medical Outcome Partnership Common Data Model (OMOP CDM) offers a standardized approach to analyzing real-world health data.
Purpose of the Study:
- To identify significant predictors of vancomycin-induced AKI.
- To leverage the OMOP CDM for robust analysis of electronic health records.
- To clarify the association between vancomycin exposure and AKI development.
Main Methods:
- Retrospective analysis of 116 patients treated with vancomycin for Staphylococcus aureus infections.
- Data collected from January 2012 to May 2022, including vancomycin concentrations and baseline creatinine.
- Logistic regression models employed to determine odds ratios for AKI predictors.
Main Results:
- High baseline serum creatinine, intensive care unit (ICU) admission, and concurrent renal disorders were significantly associated with vancomycin-induced AKI.
- Vancomycin trough levels and area under the curve (AUC) were not statistically significant predictors, despite being higher in AKI patients.
- A higher proportion of AKI patients had trough levels > 20 mg/L at the third measurement.
Conclusions:
- Underlying renal disease and ICU admission are stronger predictors of vancomycin-induced AKI than pharmacokinetic parameters.
- Current clinical practices may involve vancomycin concentration-based dosing, potentially masking direct PK/PD relationships with AKI.
- Further prospective studies are needed to validate these findings and inform AKI prevention strategies.
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