Kidney International May 2010 issue talks about the recent changes in vancomycin dosing and how it is affecting the renal community. Due to increase in vancomycin resistance and treatment failure, the infectious disease societies have advocated new guidelines to keep levels of the drug at 15-20 from the older 10-14 ranges. The articles reviews that these high trough levels might be associated with nephrotoxicity.
Just in the recent 2010 NKF spring meetings, I saw a poster presentation that talked about a series of vancomycin induced ATN toxicity likely as a result of this high trough range. The risk is incremental and the higher the trough levels and longer the duration of vancomycin use puts you at a higher risk. This paper suggests that perhaps patients with already existing renal disease as well as patients with acute renal failure and critically ill might be more prone to get worsening renal damage.
A nice table in the paper reviews the studies that showed these nephrotoxicities. How this will affect the ESRD patients is still unclear.
image source: www.3dchem.com
- ► 2018 (27)
- ► 2017 (52)
- ► 2016 (45)
- ► 2015 (63)
- ► 2014 (95)
- ► 2013 (133)
- ► 2012 (201)
- ► 2011 (370)
- JOURNAL CLUB: Metabolic Acidosis and improving GFR...
- The Online Transplant Center: Kidney Biopsy in Hea...
- Kidney Biopsy in Heart Transplant Candidates?
- TOPIC DISCUSSION: Cellular Senescence and Renal Ag...
- CLINICAL CASE 12
- CLINICAL CASE 11
- IN THE NEWS ---> Vancomycin and the kidney
- TOPIC DISCUSSION: Smoking and Kidney Disease
- The Online Transplant Center: Dual Liver and Kidne...
- The Online Transplant Center: HIV and the Kidney T...
- The Online Transplant Center: Obesity and Kidney T...
- Dual Liver and Kidney Transplantations
- HIV and the Kidney Transplant
- Obesity and Kidney Transplantation
- In the News: ASN website for Renal Fellows
- TOPIC DISCUSSION: Adolescents and Disease
- TOPIC DISCUSSION: Why do AVG and AVF get stenosis?...
- NKF reports
- CONSULT ROUNDS
- TOPIC DISCUSSION: Asymptomatic Hyponatremia
- IN THE NEWS- RENAL ANGINA SYNDROME
- CLINICAL CASE 10, ANSWER AND SUMMARY
- TOPIC DISCUSSION: PHOSPHATE BINDERS
- TOPIC DISCUSSION: A rare case of statin induced rh...
- IN THE NEWS: GLOSEN Study
- IN THE NEWS: Dialysis Time
- TOPIC DISCUSSION: Albuminuria and Proteinuria
- The Online Transplant Center: Antibody Mediated Re...
- Antibody Mediated Rejection Review
- The Online Transplant Center: Bone marrow transpla...
- Bone marrow transplantation and solid organs
- IN THE NEWS: Tyrosine Kinase Inhibitors and CKD
- IN THE NEWS- MORE NEPHROLOGY CONSULTS
- ▼ April (33)