Vancomycin-Associated Nephrotoxicity: The Obesity Factor

Surgical Infections
Stephen W DaviesR G Sawyer

Abstract

Current recommendations suggest that vancomycin dosing utilize actual rather than ideal body weight in obese patients. Thus, obese patients may be at greater risk for nephrotoxicity. The purpose of this study was to compare the incidence of nephrotoxicity in vancomycin-treated obese and lean patients at our institution, where unadjusted, actual body weight-based dosing (capped at 2 g per dose twice daily) is used. We expected obese patients to experience a greater incidence of nephrotoxicity than lean patients. This study examined a retrospective cohort of patients treated with vancomycin for gram-positive or mixed infections in our facility from 2005-2009 who were not receiving hemodialysis at the time of admission. Patients were stratified by body mass index (BMI; obese ≥30 kg/m(2) vs. lean <30 kg/m(2)). Relative risk (RR), 95% confidence intervals (CIs), and p values were computed using a generalized estimating equation to accommodate a correlated data structure corresponding to multiple episodes of infection per individual. Multivariable analysis was performed. A total of 530 patients (207 obese; 323 lean) with 1,007 episodes of infection were treated with vancomycin. Patient demographics, co-morbidities, sites of infection...Continue Reading

References

Apr 1, 1990·The Journal of Antimicrobial Chemotherapy·M J RybakP H Chandrasekar
Aug 1, 1989·Archives of Internal Medicine·N J DownsG R Hodges
Jan 1, 1983·Toxicology and Applied Pharmacology·C H KuoJ B Hook
Apr 1, 1982·Antimicrobial Agents and Chemotherapy·R A BlouinW O Griffen
Jun 1, 1993·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·P O AttmanP Alaupovic
Jun 19, 1998·Therapeutic Drug Monitoring·S R PenzakS L Hickerson
Dec 22, 1998·European Journal of Clinical Pharmacology·L A BauerJ S Lill
Jul 21, 1999·Kidney International. Supplement·P O AttmanO Samuelsson
Jan 5, 2000·Kidney International·J H DominguezR Peterson
Jun 18, 2003·The American Journal of the Medical Sciences·Errol D CrookHerman A Taylor
Dec 3, 2005·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Donald P Levine
Mar 28, 2006·Journal of the American Society of Nephrology : JASN·Roberto TrevisanGiuseppe Lepore
Jan 30, 2008·Antimicrobial Agents and Chemotherapy·Thomas P LodiseG L Drusano
May 27, 2008·The American Journal of Medicine·Ronald G HallRoger Bedimo
Jul 10, 2009·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Thomas P LodiseGeorge L Drusano
Jan 28, 2010·The American Journal of Medicine·Kathleen A HazlewoodRonald G Hall
Aug 20, 2010·Diabetology & Metabolic Syndrome·Alfredo HalpernMarcia Nery
Dec 7, 2010·International Journal of Antimicrobial Agents·Annie Wong-BeringerPaul Beringer
Feb 2, 2011·Clinical Pediatrics·Brady S MoffettMorven S Edwards
Mar 18, 2011·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·Julie V B LeongMichaele Winter
Oct 21, 2011·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·Misty MillerPeter N Johnson
Jan 31, 2012·Clinical Therapeutics·Ennie L CanoUNKNOWN Improving Medicine through Pathway Assessment of Critical Therapy of Hospital-Acquired Pneumonia (IMPACT-HAP) Study Group
Feb 1, 2012·Current Hypertension Reports·Leonard GyebiEfrain Reisin
Mar 14, 2012·European Journal of Clinical Pharmacology·Sepideh ElyasiAmirhooshang Mohammadpour
May 23, 2012·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·David C ReynoldsC Andrew DeRyke
Sep 22, 2012·European Journal of Clinical Pharmacology·Sepideh ElyasiSimin Dashti-Khavidaki
Oct 9, 2012·Current Opinion in Infectious Diseases·Brett Janson, Karin Thursky
Oct 26, 2013·The Journal of Trauma and Acute Care Surgery·Stephen W DaviesRobert G Sawyer
Feb 26, 2014·The Journal of Surgical Research·Stephen W DaviesPeter T Hallowell
Mar 4, 2014·Endocrinology and Metabolism Clinics of North America·Susan L Samson, Alan J Garber

❮ Previous
Next ❯

Citations

May 6, 2017·Clinical Pharmacology and Therapeutics·E J FilipponeJ L Farber
Jul 16, 2017·The Annals of Pharmacotherapy·Yookyung Christy ChoiJames M Hollands
Jun 14, 2016·Therapeutic Advances in Endocrinology and Metabolism·Oluwatoyin Bamgbola
May 1, 2018·Nephron·Juan Carlos Q VelezGautam M Phadke
Oct 4, 2018·PloS One·Brady S MoffettAyse Akcan-Arikan
Jan 10, 2019·Clinical and Experimental Pharmacology & Physiology·Welder ZamonerDaniela Ponce
Feb 12, 2019·Journal of Toxicologic Pathology·Masaki TakigawaAkihito Ishigami
Jun 17, 2020·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·Jaclyn A CusumanoKerry L LaPlante

❮ Previous
Next ❯

Software Mentioned

SAS

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.