Analysis Of Risk Factors For Vancomycin-Induced Acute Kidney Injury In ICU Patients

Background: Vancomycin is a glycopeptide antibiotic widely used in the management of meticillin-resistant Staphylococcus aureus(MRSA)but has been associated with significant nephrotoxicity.Many factors have found effect on kidney function,however,it remains uncertain,to what extent vancomycin is directly responsible.Aims:Objective was to investigate risk factors of vancomycin-induced acute kidney injury(VI-AKI)in intensive care unit(ICU)patients,in order to provide suggestions for improving the prevention and treatment of VI-AKI in ICU patients.Methods: A prespective study was conducted.Data of patients who used vancomycin during January 2017 to November 2017 in Emergency intensive care unit(EICU)of our hospital were collected and analyzed.And we compared the VI-AKI with NO-AKI patients.A total of 58 patients were entered in this study,who were divided into 13 patients with AKI(AKI group)and 45 patients without AKI(NO-AKI group).The clinical data of the two groups were compared by univariate analysis.Multiple logistic regression analysis was used to analyze the risk factors of VI-AKI in critically ill patients.Result: A total of 58 patients were entered in this study.Of them,38 patients were male and 20 were female with the media age was 53 years.13 patients(22.4%)developed AKI.Compared with NO-AKI group,AKI group had a high ratio of hyperuricemia and combined with diuretic and vasoactive drugs,and serum albumin level was low(P<0.05).Multiple logistic regression analysis revealed that hyperuricemia and diuretics([OR]=15.57,p=0.004;[OR]=12.82,p=0.015)was independent risk factors for VI-AKI;serum albumin valley([OR]=0.083;p=0.038)was determined to be independent protective factor for VI-AKI.Conclusions: Hyperuricemia and combined diuretics are independent risk factors for VI-AKI in severe patients,and serum albumin levels are independent protective factors.The ICU patients treated with vancomycin exist the situations below: We recommend patients concomitant with hyperuricemia should be paid more attention and a higher serum albumin was more recommend.