title: Acute renal insufficiency during telavancin therapy in clinical practice.
abstract: OBJECTIVE
  To describe the tolerance to long-term telavancin therapy among inpatients as it relates to nephrotoxicity.
  
  
  METHODS
  Retrospective cohort study of adult patients who received telavancin at the Barnes-Jewish Hospital from 1 September 2009 to 1 December 2010. Patients who received less than three doses of telavancin, were on haemodialysis prior to telavancin administration or died within 48 h of initial telavancin administration were excluded.
  
  
  RESULTS
  Twenty-one patients received telavancin and met the inclusion criteria. Seven of 21 patients (33%) developed acute renal insufficiency during therapy. Patients who developed acute renal insufficiency had a mean glomerular filtration rate reduction of 56 mL/min/1.73 m(2). In the univariate analysis, high body mass index (P=0.025), use of intravenous contrast dye (P=0.017) and prior serum vancomycin trough levels >20 mg/L (P=0.017) were associated with developing acute renal insufficiency. Two patients required haemodialysis; two had persistent renal insufficiency.
  
  
  CONCLUSIONS
  Supratherapeutic vancomycin trough levels, high body mass index and receipt of intravenous contrast dye prior to telavancin therapy were associated with acute renal insufficiency.
authors.affiliation: Infectious Diseases Division, Washington University School of Medicine, St Louis, MO 63110-1093, USA. marcoslrz@yahoo.com
authors.forename: Luis A
authors.initials: LA
authors.lastname: Marcos
authors.forename: Bernard C
authors.initials: BC
authors.lastname: Camins
authors.forename: David J
authors.initials: DJ
authors.lastname: Ritchie
authors.forename: Ed
authors.initials: E
authors.lastname: Casabar
authors.forename: David K
authors.initials: DK
authors.lastname: Warren
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced*; D000328:Adult; D000368:Aged; D000617:Aminoglycosides / Q000008:administration & dosage* / Q000009:adverse effects*; D000890:Anti-Infective Agents / Q000008:administration & dosage* / Q000009:adverse effects*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D000077427:Lipoglycopeptides; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000150:complications / Q000188:drug therapy; D016019:Survival Analysis
chemical_list: D000617:Aminoglycosides; D000890:Anti-Infective Agents; D000077427:Lipoglycopeptides; C487637:telavancin