Drug-Induced Kidney Disease- Vanco Induced AKI

Question 1

Quick recap: what’s AKI?

Answer 1

SCr increase of 0.3mg/dl in a 48-hour period or a 50% increase from baseline in a 7-day period

Question 2

Mechanism of vanco-associated AKI

Answer 2

Unknown lol, thinks that AIN might play a role but reports of ATN, oxidative stress, and complement fixation too

Question 3

Vanco-associated risk factors for AKI

Answer 3

TROUGH CONCENTRATIONS 15-20mg/dl
DAILY DOSE >4g
24-HOUR AUC >600mcg*h/L
Duration of therapy >7 days
Severity of illness
Weight >101.4kg
CONCOMITANT NEPHROTOXIC AGENTS (PIP/TAZO)

Question 4

Vanco-associated AKI prevention

Answer 4

Antimicrobial stewardship
Concomitant drugs: avoid with AGs if possible, use alternates like cefepime if suitable
Frequent monitoring in high-risk patients

Question 5

What trough concentrations and AUC should you avoid in vanco-associated AKI to prevent it?

Answer 5

Trough: >15-20mg/dl
AUC: >600 mcg*h/L