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Volume 37 Issue 3
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Article Navigation >  Journal of Pharmaceutical Practice and Service  > 2019  >  37(3): 274-278

LU Haodi, TANG Lian, FANG Jie, XUE Shengmin, SHANG Erning, XUE Sudong. Drug monitoring of acute kidney injury induced by vancomycin in patients with augmented renal clearance[J]. Journal of Pharmaceutical Practice and Service, 2019, 37(3): 274-278. doi: 10.3969/j.issn.1006-0111.2019.03.017
Citation: LU Haodi, TANG Lian, FANG Jie, XUE Shengmin, SHANG Erning, XUE Sudong. Drug monitoring of acute kidney injury induced by vancomycin in patients with augmented renal clearance[J]. Journal of Pharmaceutical Practice and Service, 2019, 37(3): 274-278. doi: 10.3969/j.issn.1006-0111.2019.03.017
shu

Drug monitoring of acute kidney injury induced by vancomycin in patients with augmented renal clearance

doi: 10.3969/j.issn.1006-0111.2019.03.017
  • 1.

    Department of Pharmacy, Suzhou Hospital Affiliated to Nanjing Medical University, Suzhou 215002, China

  • 2.

    Department of Pharmacy, Ruijin Hospital Affiliated to School of Medicine, Shanghai Jiaotong University, Shanghai 200025, China

  • Received Date: 2018-12-19
  • Rev Recd Date: 2019-03-22
  • Objective To investigate the causes of acute kidney injury in patients with augmented renal clearance during individualized application of vancomycin. Methods Three cases of acute kidney injury caused by vancomycin in our hospital were taken pharmaceutical care.The reasons for the inaccuracy of using population pharmacokinetic software to predict the trough concentration of vancomycin were analyzed,and the causes of acute kidney injury caused by vancomycin were found. Results After ascertaining the causes of the adverse reactions of the patients,targeted treatment was carried out,and all of them were well controlled and turned over. Conclusion The main causes of vancomycin-associated renal damage in patients with augmented renal clearance were combined the use of nephrotoxic drugs and renal perfusion insufficiency.It is necessary to strengthen drug monitoring in clinical medication to improve the safety of vancomycin.
  • [1] MAHMOUD S H,SHEN C.Augmentedrenal clearance in critical illness:An important consideration in drug dosing[J].Pharmaceutics,2017,9(3):E36.
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    [3] BAMGBOLA O.Review of vancomycin-induced renal toxicity:an update[J].Ther Adv Endocrinol Metab,2016,7(3):136-147.
    [4] 何娟,杨婉花.基于群体药动学的万古霉素个体化给药模式的建立和临床应用[J].中国临床药学杂志,2015,24(1):27-31.
    [5] 汤月秋,杨立川.心脏术后并发急性肾损伤的危险因素分析[J].实用医院临床杂志,2018,15(6):68-71.
    [6] 钟少榕,滕杰.心脏手术围术期血压管理与急性肾损伤[J].中华肾脏病杂志,2018,34(3):232-235.
    [7] 中国医药教育协会感染疾病专业委员会.抗菌药物药代动力学/药效学理论临床应用专家共识[J].中华结核和呼吸杂志, 2018,41(6):409-446.
    [8] EIDELSON A,MULDER B,KARCUTSKIE A,et al. 81augmented creatinine clearance in severely injured burn patients[J].J Burn Care Res,2018,39(suppl_1):S45-S46.
    [9] 陆灏迪,唐莲,薛盛敏,等.万古霉素群体药代动力学在肾功能亢进患者中的临床验证[J].中华危重病急救医学,2018,30(5):444-448.
    [10] 万古霉素临床应用剂量专家组.万古霉素临床应用中国专家共识(2011版)[J].中国新药与临床杂志,2011,30(8):561-573.
    [11] BRUSSELAERS N,MONSTREY S,COLPAERT K,et al. Outcome of acute kidney injury in severe burns:a systematic review and meta-analysis[J].Intensive Care Med,2010,36(6):915-925.
    [12] HIDAYAT L K,HSU D I,QUIST R,et al. High-dose vancomycin therapy for methicillin-resistant Staphylococcus aureus infections:efficacy and toxicity[J].Arch Intern Med,2006,166(19):2138-2144.
    [13] LIU C,BAYER A,COSGROVE S E,et al. Clinical practice guidelines by the infectious diseases society of america for the treatment of methicillin-resistant Staphylococcus aureus infections in adults and children[J].Clin Infect Dis,2011,52(3):e18-e55.
    [14] SIME F B,UDY A A,ROBERTS J A.Augmented renal clearance in critically ill patients:etiology,definition and implications for beta-lactam dose optimization[J].Curr Opin Pharmacol,2015,24:1-6.
    [15] CHU Y,LUO Y F,QU L Y,et al. Application of vancomycin in patients with varying renal function,especially those with augmented renal clearance[J].Pharm Biol,2016,54(12):2802-2806.
    [16] 唐莲,陆灏迪,薛盛敏,等.肾功能亢进患者万古霉素的药代动力学及谷浓度影响因素研究[J].国际医药卫生导报,2018,24(5):621-628.
    [17] BAKKE V,SPORSEM H,VON DER LIPPEE,et al. Vancomycin levels are frequently subtherapeutic in critically ill patients:a prospective observational study[J].Acta Anaesthesiol Scand,2017,61(6):627-635.
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Drug monitoring of acute kidney injury induced by vancomycin in patients with augmented renal clearance

doi: 10.3969/j.issn.1006-0111.2019.03.017
  • 1. Department of Pharmacy, Suzhou Hospital Affiliated to Nanjing Medical University, Suzhou 215002, China
  • 2. Department of Pharmacy, Ruijin Hospital Affiliated to School of Medicine, Shanghai Jiaotong University, Shanghai 200025, China
  • Received Date: 2018-12-19
  • Rev Recd Date: 2019-03-22

Abstract: Objective To investigate the causes of acute kidney injury in patients with augmented renal clearance during individualized application of vancomycin. Methods Three cases of acute kidney injury caused by vancomycin in our hospital were taken pharmaceutical care.The reasons for the inaccuracy of using population pharmacokinetic software to predict the trough concentration of vancomycin were analyzed,and the causes of acute kidney injury caused by vancomycin were found. Results After ascertaining the causes of the adverse reactions of the patients,targeted treatment was carried out,and all of them were well controlled and turned over. Conclusion The main causes of vancomycin-associated renal damage in patients with augmented renal clearance were combined the use of nephrotoxic drugs and renal perfusion insufficiency.It is necessary to strengthen drug monitoring in clinical medication to improve the safety of vancomycin.

LU Haodi, TANG Lian, FANG Jie, XUE Shengmin, SHANG Erning, XUE Sudong. Drug monitoring of acute kidney injury induced by vancomycin in patients with augmented renal clearance[J]. Journal of Pharmaceutical Practice and Service, 2019, 37(3): 274-278. doi: 10.3969/j.issn.1006-0111.2019.03.017
Citation: LU Haodi, TANG Lian, FANG Jie, XUE Shengmin, SHANG Erning, XUE Sudong. Drug monitoring of acute kidney injury induced by vancomycin in patients with augmented renal clearance[J]. Journal of Pharmaceutical Practice and Service, 2019, 37(3): 274-278. doi: 10.3969/j.issn.1006-0111.2019.03.017
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