Comparative Incidence of Nephrotoxicity by Age Group among Adult Patients Receiving Vancomycin

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• 作者：Joseph J. Carreno (1) (2)
  Anthony Jaworski (1) (2)
  Rachel M. Kenney (1) (2)
  Susan L. Davis (1) (2)
  
• 关键词：Acute kidney injury ; Aged ; Drug toxicity ; Elderly ; Infectious diseases ; Nephrotoxicity ; Vancomycin
• 刊名：Infectious Diseases and Therapy
• 出版年：2013
• 出版时间：December 2013
• 年：2013
• 卷：2
• 期：2
• 页码：201-208
• 全文大小：
• 作者单位：Joseph J. Carreno (1) (2)
  Anthony Jaworski (1) (2)
  Rachel M. Kenney (1) (2)
  Susan L. Davis (1) (2)
  
  1. Henry Ford Hospital Department of Pharmacy Services, Detroit, MI, USA
  2. Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, 259 Mack. Ave., Detroit, MI, 48201, USA
  
• ISSN：2193-6382

文摘

Introduction Little is known regarding age-related risk of nephrotoxicity during vancomycin therapy after the publication of the 2009 vancomycin consensus guidelines for therapeutic drug monitoring. We sought to evaluate incidence and risk factors for acute kidney injury in three age groups. Methods Matched cohort study of patients receiving vancomycin, grouped by age: young adults (184years), older adults (659years) and very elderly (0years), matched on previously published risk factors for nephrotoxicity. Outcomes included traditional vancomycin nephrotoxicity and Acute Kidney Injury Network-modified definition of nephrotoxicity. Results The incidence of acute kidney injury was 34.1% vs. 34.1% vs. 31.8% in the young, older adults and very elderly groups, respectively (p=0.97). In the logistic regression model, after adjusting for baseline risk factors, age was not a significant predictor of acute kidney injury. Lower respiratory tract infection (adjusted odds ratio [aOR] 5.18; 95% confidence interval [CI] 2.152.41) and duration of treatment (aOR 1.12; 95% CI 1.03.22) were found to be independently associated with outcome. Conclusion No differences in risk of acute kidney injury were identified between young, older, and very elderly adults when adjusting for other risk factors. Further research is required to identify strategies to optimize the safety of vancomycin in the aging population.