Are Blacks at Higher Risk for Vancomycin-Related Acute Kidney Injury?
Autor: Sharma, Mamta; Braekevelt, Kaylin; Kale-Pradhan, Pramodini; Szpunar, Susan; Khatib, Riad
Publication year: 2020
Journal of pharmacy practice
issn:1531-1937 0897-1900
doi: 10.1177/0897190018800093
Abstract:
BACKGROUND: Black individuals have a higher lifetime risk of acute kidney injury (AKI) and chronic kidney disease than whites. Vancomycin has a potential for nephrotoxicity. The objective of this study was to determine whether the incidence of AKI among patients being treated with vancomycin differs by race. METHODS: Retrospective study of adult ((3) ≥18 years) inpatients who were on vancomycin for (3)48 hours between January 2012 and December 2014. Data on demographics, comorbid conditions, clinical characteristics, vancomycin dose, duration, and nephrotoxic drugs were collected. Patients with a creatinine clearance <30 mL/min or undergoing dialysis were excluded. RESULTS: We identified 1130 patients during the study period; 48.1% (544) were black. The overall incidence of AKI was 8.2% (10.1% blacks, 6.5% whites; P = .03). Independent predictors of AKI included black race (P = .011); higher Charlson score (P = .006); higher body mass index (BMI; P = .002); higher vancomycin trough level (P < .0001); and sepsis/systemic inflammatory response syndrome (<.0001), pneumonia (P = .001) or gastrointestinal/genitourinary (P = .025) as the source of infection. CONCLUSION: The incidence of vancomycin-related AKI was higher in blacks, independent of other risk factors. Based on our study, vancomycin trough levels and renal function need to be closely monitored in blacks. Language: eng Rights: Pmid: 30669919 Tags: Humans; Adult; Retrospective Studies; Risk Factors; race; Black or African American; vancomycin; Anti-Bacterial Agents/adverse effects; *Acute Kidney Injury/chemically induced/diagnosis/epidemiology; *Vancomycin/adverse effects; renal Link: https://pubmed.ncbi.nlm.nih.gov/30669919/
