From: Vancomycin dosing design method considering risk factors for nephrotoxicity
Patients without Nephrotoxicity | Patients with Nephrotoxicity | p-value | |||||
---|---|---|---|---|---|---|---|
(n = 165) | (n = 47) | ||||||
Age (years) | 79 | [34–96] | 79 | [19–98] | 0.653†) | ||
Sex (M/F) | 90/75 | 27/20 | - | ||||
Height (cm) | 160 | [137–180] | 160 | [137.5–178] | 0.988†) | ||
Weight (kg) | 51.3 | [29.2-135.7] | 49.1 | [27.0-110.9] | 0.633†) | ||
Ccr (mL/min) | 49.6 | [4.9–120] | 54.4 | [20.5–120] | 0.385†) | ||
BMI | 20.0 | [12.5–49.8] | 20.5 | [11.7–45.0] | 0.650†) | ||
Dehydration‖) | 118 | (71.5%) | 33 | (70.2%) | 0.862‡) | ||
General blood tests | |||||||
WBC×103 (/µL) | 90.0 | [1-405] | 93.0 | [3-242] | 0.406†) | ||
Plt×104 (/µL) | 18.0 | [0.2–66.6] | 17.2 | [1.5–59.7] | 0.911†) | ||
Blood biochemical tests | |||||||
Alb (g/dL) | 2.4 | [1.3–4.3] | 2.3 | [1.3–3.7] | 0.214†) | ||
T-Bil (mg/dL) | 0.6 | [0.2–9.5] | 0.8 | [0.2–5.6] | 0.154†) | ||
AST (IU/L) | 23.0 | [6.0-324] | 35.0 | [10–155] | 0.009†) | ||
ALT (IU/L) | 17.5 | [2.0-495] | 26.0 | [4.0-217] | 0.053†) | ||
BUN (mg/dL) | 20.1 | [4.3–145] | 20.8 | [6.9–63.2] | 0.948†) | ||
Cr (mg/dL) | 0.74 | [0.25–6.7] | 0.63 | [0.27–2.7] | 0.428†) | ||
CRP (mg/dL) | 7.5 | [0.04–39.2] | 7.8 | [0.32–27.3] | 0.817†) | ||
High dose of VCM (4 g/day) | 2 | (1.2%) | 3 | (6.4%) | 0.074§) | ||
Cumulative Dose (g) | 13.5 | [2.75–82.5] | 16.0 | [3.0–65.0] | 0.622†) | ||
Loading dose ≥ 25 mg/kg | 103 | (62.4%) | 30 | (63.8%) | 0.860‡) | ||
Initial Dose (mg/kg) | 26.0 | [7.5–46.7] | 25.6 | [9.0-55.6] | 0.180†) | ||
Maintenance Dose (mg/kg/day) | 25.7 | [3.5–63.9] | 28.3 | [5.4–62.3] | 0.397†) | ||
Date of the first blood concentration measurement (day) | 4 | [3–10] | 4 | [3–8] | 0.157†) | ||
Number of peak blood concentration measurements | 1 | [1–7] | 2 | [1–6] | 0.130†) | ||
Number of trough blood concentration measurements | 2 | [1–7] | 2 | [1–6] | 0.116†) | ||
Peak blood concentration (µg/mL) | 24.7 | [5.9–68.5] | 29.0 | [16.7-120.4] | < 0.0001†) | ||
Trough blood concentration (µg/mL) | 15.4 | [3.0-47.9] | 19.3 | [9.5–49.8] | < 0.0001†) | ||
Initial Blood Sampling Measured AUC (mg·h/L) | 487 | [237–1451] | 628 | [275–1975] | < 0.0001†) | ||
AUCss (mg·h/L) | 551 | [230–1036] | 656 | [287–1984] | < 0.0001†) | ||
Cumulative AUC (mg·h/L) ¶) | 6001 | [1011–37078] | 5877 | [1117–29657] | 0.796†) | ||
Days of administration (days) | 11.0 | [3–43] | 14.0 | [3–47] | 0.022†) | ||
Periods before the onset of nephrotoxicity (days) | 11.0 | [3–43] | 11.0 | [3–47] | 0.437†) | ||
Dosing for more than 14 days | 59 | (35.8%) | 24 | (51.1%) | 0.058‡) | ||
Comorbid disease | |||||||
Heart failure | 53 | (32.1%) | 19 | (40.4%) | 0.289‡) | ||
Arrhythmia | 32 | (19.4%) | 14 | (29.8%) | 0.127‡) | ||
Renal diseases caused by underlying conditions | 30 | (18.2%) | 13 | (27.7%) | 0.154‡) | ||
Chronic hepatic disease | 8 | (4.8%) | 7 | (14.9%) | 0.026‡) | ||
Diabetes mellitus | 51 | (30.9%) | 12 | (25.5%) | 0.477‡) | ||
Malignant tumor | 31 | (18.8%) | 6 | (12.8%) | 0.337‡) | ||
Sepsis | 26 | (15.8%) | 6 | (12.8%) | 0.613‡) | ||
Concomitant medications*) | |||||||
TAZ/PIPC | 14 | (8.5%) | 9 | (19.1%) | 0.038‡) | ||
Aminoglycosids#) | 1 | (0.6%) | 3 | (6.4%) | 0.035§) | ||
Diuretic | 59 | (35.8%) | 27 | (57.4%) | 0.008‡) | ||
NSAIDs | 20 | (12.1%) | 11 | (23.4%) | 0.053‡) | ||
Acetaminophen | 37 | (22.4%) | 12 | (25.5%) | 0.656‡) | ||
ACE inhibitors | 2 | (1.2%) | 2 | (4.3%) | 0.214§) | ||
ARB | 38 | (23.0%) | 8 | (17.0%) | 0.378‡) | ||
Catecholamine | 28 | (20.0%) | 9 | (19.1%) | 0.728‡) | ||
Immunosuppressive drug | 31 | (18.8%) | 9 | (19.1%) | 0.956‡) | ||
anticancer drug | 7 | (4.2%) | 1 | (2.1%) | 0.871§) | ||
Contrast agent | 1 | (0.6%) | 1 | (2.1%) | 0.395§) |