Accelerated Acute Tubular Necrosis Due to Vancomycin

Shah, Sunay; Nasiri, Papia; Vázquez, José Antonio

doi:10.1097/ipc.0b013e3182769291

Cited by 2 publications

(1 citation statement)

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“…No alternative explanation was deemed plausible. In addition, we extracted 4 cases from the published literature that describe a similar pattern of serum creatinine rise, which was not specifically highlighted by the authors [22-25]. Furthermore, we compared the pattern of rise in serum creatinine with that of a random cohort of cases on AKI from other aetiologies.…”

Section: Introductionmentioning

confidence: 99%

Vancomycin-Associated Acute Kidney Injury with a Steep Rise in Serum Creatinine

Obadan

Kaushal

Alzubaidi

et al. 2018

Nephron

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Background: Vancomycin-associated (VA) acute kidney injury (AKI) is being increasingly recognized. A distinct pattern of rapid rise in serum creatinine (sCr) during VA-AKI has occasionally been observed. However, such scenarios remain underreported. Methods: We conducted an online survey at the American Society of Nephrology Communities forum and reviewed publications of VA-AKI via PubMed or Google searching for cases of precipitous AKI (those with rise in sCr ≥1.5 mg/dL/day) attributable to vancomycin. Results: We identified 12 original cases compiled from 6 different hospitals and 4 published cases (n = 16; 38% women, age 43.5 ± 16 years, weight 108 ± 23 kg, body mass index 35 ± 7 kg/m²) of precipitous AKI observed shortly after large cumulative doses of VA (8.8 ± 5 g). The median steepest 24-h rise in sCr was 2.6 mg/dL (range 1.5–3.5 mg/dL) and the slope of the initial 48-h sCr rise was greater than that of a control AKI (non-VA, n = 48) group (2.03 ± 0.1 vs. 0.62 ± 0.0 mg/dL/day; p < 0.0001). The steep rise in sCr in the VA-AKI was not accompanied by anuria. Overt rhabdomyolysis was absent in all cases. Further, in 3 precipitous VA-AKI cases, simultaneous serum cystatin C values did not rise precipitously, suggesting that the reductions in glomerular filtration rate were overestimated by the sCr increase. Conclusions: VA-AKI can manifest with a precipitous rise in sCr shortly after a high cumulative dose of vancomycin. True toxic tubular injury overrepresented by the sCr rise is postulated.

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Section: Introductionmentioning

confidence: 99%