title: Vancomycin-associated renal dysfunction: where are we now?
abstract: Vancomycin has been in clinical use for over 60 years, during which time renal toxicity has been well documented. Multiple risk factors and outcomes are associated with vancomycin-related nephrotoxicity. Risk factors include vancomycin exposure (trough levels 15 mg/L or higher, larger area under the curve, duration of therapy), host susceptibility to vancomycin (increased body weight, preexisting renal dysfunction, critical illness), and concurrent nephrotoxin therapy. Nephrotoxicity is associated with prolonged hospital stays, mortality, and the need for renal replacement therapy. To what degree vancomycin-associated nephrotoxicity exacerbates these adverse clinical outcomes remains unclear. This article reviews the current evidence on vancomycin-associated nephrotoxicity and explores future research directions with potential implications for improved patient safety.
authors.affiliation: Department of Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, Albany College of Pharmacy and Health Sciences, Albany, New York.
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Carreno
authors.forename: Rachel M
authors.initials: RM
authors.lastname: Kenney
authors.forename: Ben
authors.initials: B
authors.lastname: Lomaestro
mesh_terms: D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000493:pharmacokinetics; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced* / Q000517:prevention & control; D014640:Vancomycin / Q000009:adverse effects* / Q000493:pharmacokinetics
chemical_list: D000900:Anti-Bacterial Agents; D014640:Vancomycin
keywords: acute kidney injury; nephrotoxicity; vancomycin