Incidence and predictors of vancomycin nephrotoxicity and mortality in patients with chronic liver disease: a two-center retrospective cohort study

• DOI: 10.1186/s12879-025-10763-3
• Publication Date: 2025-03-18T09:03:48Z
• Authors: Reem F. Bamogaddam; Ahmad Alamer; Shatha Alqarni; Mohammed M. Almot...; Ali A. Almakrami; Alwaleed M. Alharbi; Raghad Alamri; Manar Altamimi; Amal Alkhulaif; Raghad Alanazi; Omar A. Almohammed; Majed S. Al Yami
• Keywords: Nephrotoxicity; Medical microbiology

Patients with liver disease express multiple pathophysiological variations that alter the pharmacokinetics of numerous drugs. At this time, there is insufficient evidence about proper dosing vancomycin in patients disease. This study aimed to assess risk acute kidney injury (AKI) during therapy and identify predictors AKI all-cause mortality among varying degrees dysfunction. A retrospective cohort was conducted including chronic who used hospitalization from January 2016 2024 two Saudi hospitals. were grouped by severity (mild [MLD] or moderate-to-severe [MSLD] based on Child–Pugh score). The incidence AKI, mean trough level, compared between groups. multivariable logistic regression model employed mortality. total 110 treated included (28 had MLD 82 MSLD). higher MSLD than those observed (28% vs. 14.3%, respectively; p = 0.1440), but difference statistically insignificant. levels (12.9 ± 5.2 μmol/L 10.2 4.7 μmol/L, 0.0143) percentage level > 13.8 (35.4% 10.7%, 0.0131) significantly group group. Having a Creatinine Clearance (CrCl) 15.1–29.9 ml/min (adjusted Odds ratio [aOR]: 45.5; 95% Confidence interval [CI] 4.99–414.8), (aOR: 7.67; 95%CI 2.49–23.63) associated development. Similarly, (23.2% 3.6%, 0.0203). having body mass index (BMI) 25–29.9 kg/m2 (sOR 6.69; 1.73–25.8), an albumin < 25 g/L 4.33; 1.36–13.8), 6.13; 1.82–20.6). MLD; increases as progresses. Thus, existence should be considered when monitoring toxicity minimize adverse outcomes Larger studies are needed closely quantify