Related Experiment Video

Updated: Jan 12, 2026

A Novel Method to Determine the Longitudinal Antibacterial Activity of Drug-Eluting Materials
06:18

A Novel Method to Determine the Longitudinal Antibacterial Activity of Drug-Eluting Materials

Published on: March 3, 2023

1.8K

Analysis of vancomycin administration to patients with one kidney

Hitomi Motomura1, Masashi Uchida1, Shingo Yamazaki1

  • 1Graduate School of Pharmaceutical Sciences, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8675, Japan; Division of Pharmacy, Chiba University Hospital, Chiba, Japan.

Journal of Infection and Chemotherapy : Official Journal of the Japan Society of Chemotherapy
|November 1, 2025
PubMed
Abstract

Insights

Patients with a single kidney can likely receive vancomycin (VCM) using the same dosing as those with two kidneys. This study found stable kidney function and effective VCM levels in patients with one kidney on standard VCM regimens.

Area of Science:

  • Nephrology
  • Pharmacology
  • Infectious Diseases

Background:

  • Compensatory hypertrophy occurs in the remaining kidney after unilateral nephrectomy.
  • Vancomycin (VCM) is renally excreted and requires therapeutic drug monitoring to prevent nephrotoxicity and ensure efficacy.
  • Dosing guidelines for vancomycin in patients with two kidneys have not been validated for those with a single kidney.

Purpose of the Study:

  • To investigate the safety and efficacy of standard vancomycin dosing regimens in patients with a single functioning kidney.
  • To determine if patients with one kidney can be treated with vancomycin using the same dosing strategy as patients with two kidneys.

Main Methods:

  • Retrospective case series of six patients with one kidney treated with vancomycin at Chiba University Hospital.
  • Assessment of serum creatinine (Scr) and vancomycin (VCM) trough concentrations.
  • Bayesian estimation using two population pharmacokinetic (PK) models for Japanese patients with two kidneys to evaluate individual VCM PK parameters.

Main Results:

  • Six patients with a single kidney received vancomycin with median loading and maintenance doses of 20.6 mg/kg and 28.3 mg/kg/day, respectively.
  • Serum creatinine levels remained stable, with no instances of vancomycin-associated nephrotoxicity.
  • Vancomycin trough concentrations consistently stayed within the therapeutic range of 10-20 μg/mL for most patients.

Conclusions:

  • Patients with a single kidney may safely receive vancomycin with the same dosing regimen as patients with two kidneys.
  • Standard vancomycin dosing appears effective and safe in the setting of unilateral renal agenesis or nephrectomy.
Keywords:
KidneyTherapeutic drug monitoringVancomycin

More Related Videos

Comparative Proteomic Analysis of Whole Kidney, Medulla, and Cortical Tubules in Diabetic Pathogenesis of Kidney Injury in Mice10:31

Comparative Proteomic Analysis of Whole Kidney, Medulla, and Cortical Tubules in Diabetic Pathogenesis of Kidney Injury in Mice

Published on: May 2, 2025

598
A Reference Broth Microdilution Method for Dalbavancin In Vitro Susceptibility Testing of Bacteria that Grow Aerobically11:28

A Reference Broth Microdilution Method for Dalbavancin In Vitro Susceptibility Testing of Bacteria that Grow Aerobically

Published on: September 9, 2015

29.7K

Related Concept Videos

Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant01:25

Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant

In patients with renal disease, dosage adjustments are necessary to maintain therapeutic plasma drug concentrations and prevent toxicity or subtherapeutic exposure. Renal impairment alters drug pharmacokinetics, especially in conditions like uremia, where changes such as prolonged elimination half-life and altered apparent volume of distribution can significantly affect drug disposition. These changes require careful modification of the dosing regimen to achieve the desired clinical...
202
Renal Failure: Dose Adjustments01:11

Renal Failure: Dose Adjustments

In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
426
Estimation of k and VD of Aminoglycosides01:20

Estimation of k and VD of Aminoglycosides

Aminoglycosides are a class of antibiotics used to treat various bacterial infections. Clinicians must determine the elimination rate constant (k) and volume of distribution (VD) to optimize therapeutic efficacy and minimize toxicity. The k value represents the rate at which the drug is removed from the body, and the VD reflects the degree to which the drug distributes into body tissues. Accurately estimating these parameters allows healthcare professionals to tailor drug dosing to individual...
208
Determination of Multiple Dosing Parameters: Steady-State, Minimum and Maximum Concentrations01:15

Determination of Multiple Dosing Parameters: Steady-State, Minimum and Maximum Concentrations

Gentamicin, an aminoglycoside antibiotic, is commonly administered via intermittent intravenous infusion to treat severe infections. An intermittent one-hour infusion of gentamicin, administered at eight-hour intervals, allows for precise control of plasma drug concentrations, minimizing toxicity while ensuring therapeutic efficacy. Pharmacokinetic principles govern the dynamics of plasma concentrations and can be mathematically described using specific equations.The plasma drug concentration...
228
Renal Drug Excretion: Tubular Secretion01:28

Renal Drug Excretion: Tubular Secretion

Active tubular secretion is a robust, energy-demanding process that utilizes carrier systems to transport drugs into renal tubules. The active renal secretion systems include the organic anion transporter (OAT) for weak acids and the organic cation transporter (OCT) for weak bases. Structurally similar drugs can compete for the same transporter, potentially leading to drug accumulation and toxicity. However, this principle can be exploited therapeutically. One example is probenecid (Probalan),...
757
Drug Dosing in Renal Diseases: Measurement of Serum Creatinine Concentration and Clearance01:25

Drug Dosing in Renal Diseases: Measurement of Serum Creatinine Concentration and Clearance

In healthy individuals, serum creatinine levels remain stable due to a balance between its constant production—primarily from muscle metabolism—and renal excretion. Creatinine is freely filtered by the glomeruli, making it a valuable marker for estimating renal function. When the glomerular filtration rate (GFR) decreases, the kidneys can only eliminate less creatinine, causing serum levels to rise.Serum creatinine concentration is widely used to estimate creatinine clearance...
176