Are Blacks at Higher Risk for Vancomycin-Related Acute Kidney Injury?. (October 2020)

• Record Type: Journal Article
• Authors: Sharma, Mamta; Braekevelt, Kaylin; Kale-Pradhan, Pramodini; Szpunar, Susan; Khatib, Riad
• Is Part Of: Journal of pharmacy practice. Volume 33:Number 5(2020:Oct.)
• Page Start: 592
• Page End: 597
• Publication Date: 2020-10
• Subjects: race -- renal -- vancomycin; Pharmacy -- Periodicals; Pharmacology -- Periodicals; 615.1
• DOI: 10.1177/0897190018800093
• Languages: English
• ISSNs: 0897-1900

Abstract

Background: Black individuals have a higher lifetime risk of acute kidney injury (AKI) and chronic kidney disease than whites. Vancomycin has a potential for nephrotoxicity. The objective of this study was to determine whether the incidence of AKI among patients being treated with vancomycin differs by race. Methods: Retrospective study of adult ( 3 ≥18 years) inpatients who were on vancomycin for 3 48 hours between January 2012 and December 2014. Data on demographics, comorbid conditions, clinical characteristics, vancomycin dose, duration, and nephrotoxic drugs were collected. Patients with a creatinine clearance <30 mL/min or undergoing dialysis were excluded. Results: We identified 1130 patients during the study period; 48.1% (544) were black. The overall incidence of AKI was 8.2% (10.1% blacks, 6.5% whites; P = .03). Independent predictors of AKI included black race ( P = .011); higher Charlson score ( P = .006); higher body mass index (BMI; P = .002); higher vancomycin trough level ( P < .0001); and sepsis/systemic inflammatory response syndrome (<.0001), pneumonia ( P = .001) or gastrointestinal/genitourinary ( P = .025) as the source of infection. Conclusion: The incidence of vancomycin-related AKI was higher in blacks, independent of other risk factors. Based on our study, vancomycin trough levels and renal function need to be closely monitored in blacks.