title: Retrospective Analysis of Vancomycin Nephrotoxicity in Elderly Chinese Patients.
abstract: This study explored nephrotoxicity in elderly Chinese patients after exposure to vancomycin and other nephrotoxic risk factors. This was a single-center retrospective study. The patient population included those who were ≥60 years of age, had normal baseline serum creatinine values, and received vancomycin for ≥48 h between January 1, 2013 and August 30, 2014. Nephrotoxicity occurred in 29% of 124 patients. A baseline creatinine clearance ≥63.5 ml/min was more common in the nephrotoxic group. Patients with high (≥15 mg/l) rather than low (<15 mg/l) average vancomycin troughs had elevated nephrotoxicity (47.2 vs. 27.3%, p = 0.0001). Of the comorbid conditions evaluated, there were more patients with shock (p = 0.001), hypertension (p = 0.020) and congestive heart failure (p = 0.04) in the nephrotoxic group. Drugs frequently given at the same time with vancomycin, such as angiotensin receptor blockers and furosemide, were also associated with increased nephrotoxic risk. In conclusion, nephrotoxicity was frequently observed in patients with concurrent vancomycin trough concentrations ≥15 μg/ml and hypertension, shock, congestive heart failure. In addition, drugs concurrently used with vancomycin may also increase its nephrotoxicity. Therefore, renal function and vancomycin serum troughs should be closely monitored, especially in patients with other renal injury risk factors.
authors.affiliation: Department of Pharmacy, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Liu
authors.forename: You
authors.initials: Y
authors.lastname: Yin
authors.forename: Xin-Zhu
authors.initials: XZ
authors.lastname: Liu
authors.forename: Hui-Juan
authors.initials: HJ
authors.lastname: Yao
authors.forename: Li-Xia
authors.initials: LX
authors.lastname: Li
authors.forename: Ji-Hui
authors.initials: JH
authors.lastname: Chen
authors.forename: Ting
authors.initials: T
authors.lastname: Chen
authors.forename: Xiao-Tong
authors.initials: XT
authors.lastname: Lu
authors.forename: Shu-Hong
authors.initials: SH
authors.lastname: Bu
authors.forename: Jian
authors.initials: J
authors.lastname: Zhang
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000453:epidemiology; D000368:Aged; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D044466:Asian People; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014640:Vancomycin / Q000009:adverse effects*
chemical_list: D000900:Anti-Bacterial Agents; D014640:Vancomycin