title: Risk of vancomycin-induced nephrotoxicity in the population with chronic kidney disease.
abstract: The antibiotic vancomycin has been available since the 1950s but has been used more commonly since the early 1980s because of the widespread appearance of methicillin-resistant Staphylococcus aureus. Infectious Diseases Society of America guidelines recommend achieving vancomycin trough levels of 10 to 20 μg/mL. Usage of vancomycin in high dosages especially ≥ 4 g/d has led to an increase in the incidence of vancomycin-induced nephrotoxicity, particularly in patients with chronic kidney disease (CKD). This review focuses on the impact of vancomycin-induced nephrotoxicity in patients with CKD. Patients with CKD are at increased risk of developing acute kidney injury and subsequently requiring renal replacement therapy. There is substantial need for vancomycin pharmacokinetic studies to be performed in the population with CKD to develop an optimum vancomycin nomogram in these patients. At present, tight monitoring of vancomycin trough levels in the population with CKD is recommended to help prevent acute kidney injury and its associated high morbidity, mortality and health care costs.
authors.affiliation: Department of Medicine, Division of Nephrology, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama 35294-0007, USA.
authors.forename: Bhupesh
authors.initials: B
authors.lastname: Panwar
authors.forename: Victoria A
authors.initials: VA
authors.lastname: Johnson
authors.forename: Mukesh
authors.initials: M
authors.lastname: Patel
authors.forename: Daniel F
authors.initials: DF
authors.lastname: Balkovetz
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000453:epidemiology* / Q000517:prevention & control; D006801:Humans; D011159:Population Surveillance / Q000379:methods; D051436:Renal Insufficiency, Chronic / Q000188:drug therapy / Q000453:epidemiology*; D012307:Risk Factors; D014640:Vancomycin / Q000009:adverse effects*
chemical_list: D014640:Vancomycin