title: Risk factors for acute kidney injury associated with the treatment of bacterial endocarditis at a tertiary academic medical center.
abstract: BACKGROUND
  Acute kidney injury (AKI) is a common complication of endocarditis.
  
  
  OBJECTIVE
  To determine risk factors for the development of AKI in patients treated for endocarditis.
  
  
  METHODS
  This single centre, retrospective univariate and multivariate analysis to determine risk factors for the development of AKI included patients diagnosed with endocarditis between January 2009 and October 2013.
  
  
  RESULTS
  Of 211 included patients, a total of 84 (39.8%) patients developed AKI. We identified multiple independent variables associated with the development of AKI, including: age ≥ 65 years, presence of hardware, chronic kidney disease, AKI on admission, infection with Staphylococcus spp, receipt of nafcillin or oxacillin or aminoglycoside and nafcillin or oxacillin or aminoglycoside and vancomycin, vancomycin trough level ≥ 20.0 mcg/ml, aminoglycoside total daily dose reduction, duration of vancomycin exceeding three days, receipt of loop diuretic or more than three concomitant nephrotoxins and duration of loop diuretic or non-steroidal anti-inflammatory drug therapy exceeding seven days.
  
  
  CONCLUSIONS
  In patients treated for endocarditis, multiple risk factors for AKI were identified. Prospective studies are needed to evaluate these variables for causation of AKI in patients treated for endocarditis.
authors.affiliation: a Department of Pharmacy , Mayo Clinic , Rochester , MN , USA.
authors.forename: Brianne M
authors.initials: BM
authors.lastname: Ritchie
authors.affiliation: b Department of Pharmacy Services , Brigham and Women's Hospital , Boston , MA , USA.
authors.forename: Beth A
authors.initials: BA
authors.lastname: Hirning
authors.affiliation: b Department of Pharmacy Services , Brigham and Women's Hospital , Boston , MA , USA.
authors.forename: Craig A
authors.initials: CA
authors.lastname: Stevens
authors.affiliation: c Department of Kinesiology, Health Studies Program , University of Rhode Island , Kingston , RI , USA.
authors.forename: Steven A
authors.initials: SA
authors.lastname: Cohen
authors.affiliation: b Department of Pharmacy Services , Brigham and Women's Hospital , Boston , MA , USA.
authors.forename: Jeremy R
authors.initials: JR
authors.lastname: DeGrado
mesh_terms: D000046:Academic Medical Centers / Q000379:methods; D058186:Acute Kidney Injury / Q000139:chemically induced*; D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D004697:Endocarditis, Bacterial / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D000900:Anti-Bacterial Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal
keywords: Aminoglycosides; Endocarditis; Nephrotoxicity; Renal failure; Vancomycin