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Study finds incidence and predictors of multiple vancomycin-associated AKI
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AUSTIN, Texas — A study presented at the National Kidney Foundation Spring Clinical Meetings showed data suggesting patients who had been treated with vancomycin and had acute kidney injury were at an elevated risk of subsequent acute kidney injury when re-treated with vancomycin.
“[We] know that vancomycin causes AKI, but what we don’t know is that [is it] the patient’s first AKI, is it their second AKI and what’s the likelihood of them getting another AKI when they get re-treated with vancomycin,’” study co-author Ryan J. Sangiovanni, Pharm D, of Albany College of Pharmacy and Health Sciences, told Healio Nephrology. “It’s one of those drugs that it’s kind of unique in the way that if you had adverse reaction to ‘XYZ’ drug we probably wouldn’t give it to you again, but with vancomycin — because we can monitor it — we do that.”
The retrospective cohort study consisted of more than 3,000 Veterans Affairs patients and sought to determine the frequency and predictors of subsequent vancomycin-related AKI among patients on vancomycin who previously experienced vancomycin-related AKI, according to a related abstract.
“The initial AKI was about 15%, what you would expect from the literature, but moving forward with patients that were re-treated, it was almost double that,” Sangiovanni said. “So, it was 26% of patients who got treated with vancomycin who initially got an AKI, got another AKI.”
The study took place during a 5-year period. The relationship between vancomycin exposure and subsequent vancomycin-related AKI warrants further investigation for reasons including weight-based dosing and patients’ APACHE scores, according to researchers.
“Some things did change throughout the timeframe, but what we found was that not only did patients have a higher likelihood of a subsequent AKI, patients that were larger [115 kg or larger] or patients who had a high APACHE score, which is basically critically illness and in and out of the ICU of 20 or more, had a higher risk of that subsequent AKI,” Sangiovanni said. – by Jake Scott and Kristine Houck, MA, ELS
Reference:
Sangiovanni RJ, et al. Poster 11. Presented at: National Kidney Foundation Spring Clinical Meetings; April 10-14, 2018; Austin, Texas.
Disclosure: Sangiovanni reports no relevant financial disclosures.