Use of vancomycin and acute kidney injury in critically ill patients with sepsis or septic shock: a retrospective observational cohort study

被引:0
作者
Gonzalez-Delgado, D. [1 ]
Vives, M. [1 ,2 ]
Monedero, P. [1 ]
Aldaz, A. [3 ]
机构
[1] Univ Navarra, Clin Univ Navarra, Dept Anestesiol & Cuidados Intens, Pamplona, Spain
[2] Inst Invest Sanitaria Navarra, IdiSNA, Pamplona, Spain
[3] UNIV NAVARRA, Clin Univ Navarra, Dept Farm, PAMPLONA, Spain
来源
REVISTA ESPANOLA DE ANESTESIOLOGIA Y REANIMACION | 2025年 / 72卷 / 02期
关键词
Acute kidney injury; Vancomycin; Sepsis; Septic shock; Nephrotoxicity; INFECTIOUS-DISEASES SOCIETY; HEALTH-SYSTEM PHARMACISTS; AMERICAN SOCIETY; NEPHROTOXICITY;
D O I
10.1016/j.redar.2024.501657
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Introduction: The independent association of vancomycin with Acute Kidney Injury (AKI) in the critically ill patient with sepsis or septic Shock is controversial. The aim of this study was to evaluate the incidence of AKI in a cohort of patients with sepsis or septic Shock with an adequate and strict monitoring of vancomycin, guided by the area under the concentration-time curve in relation to the minimum inhibitory concentration (AUC/MIC ratio). Material and methods: Retrospective cohort study on 106 patients admitted to the ICU with a diagnosis of sepsis or septic shock with vancomycin treatment, consecutively from January 2017 to December 2019. AKI was defined according to Kidney Disease Improving Global Outcomes criteria. Risk factors associated with AKI were determined by multivariable logistic regression analysis. Results: In our cohort, 28 patients out of 106 (26%) developed AKI. ICU and 30-day mortality were 18% and 22%, respectively. After multivariable logistic regression adjusted analysis, chronic liver disease was associated with AKI. Conclusion: In our retrospective cohort study on critical patients with sepsis and septic shock, treated with vancomycin adjusting the dose guided by a pharmacokinetic/pharmacodynamic monitoring to achieve the target AUC0-24/CMI ratio, the incidence of AKI was 26%. (c) 2024 The Author(s). Published by Elsevier Espana, S.L.U. on behalf of Sociedad Espanola de Anestesiolog<acute accent>& imath;a, Reanimacio<acute accent>n y Terape<acute accent>utica del Dolor. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
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页数:9
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