TABLE 1

Patient characteristics grouped by development of AKIa

VariableValue for patients with:P value
AKI (n = 20)No AKI (n = 107)
Age ≥ 70 yrs10 (50.0)44 (41.4)0.441
Male sex13 (65.0)75 (69.2)0.731
Wt, kg (range)73.5 (54–110)74.7 (39–184)0.791
Comorbidities
    Heart disease3 (15.0)25 (23.1)0.576
    Diabetes7 (35.0)36 (33.3)0.885
    Malignancy6 (30.0)30 (27.8)0.839
    Liver disease2 (10.0)7 (6.5)0.779
    Lung disease2 (10.0)14 (12.1)0.713
    Immunosuppression1 (5.0)21 (18.7)0.193
    Charlson weighted index ≥ 37 (35.0)47 (43.5)0.479
Origin of bacteremia0.011
    Community onset8 (40.0)10 (9.3)
    Hospital onset12 (60.0)97 (90.6)
Location at bacteremia0.447
    ICU6 (30.0)27 (25.2)
    Ward14 (70.0)80 (74.8)
Source of infectionb
    Low risk5 (25)33 (30.8)0.79
    Intermediate risk6 (30)44 (41.4)0.45
    High risk9 (45)30 (27.8)0.18
APACHE II score (range)13.8 (0–37)11.2 (1–30)0.224
Daily vancomycin dose, mg (median)*1,789 (750–4,000)1,880 (500–4,000)0.59
Vancomycin AUC0–24 (median)536.36440.330.02
Vancomycin trough (median)*17.2 (9–36)13.1 (4–31)0.003
Trough ≥ 15 mg/liter12 (60)38 (35.5)0.036
Cmax (median)27.4 (24.7–32.2)24.0 (23.4–25.4)0.005
Cmin (median)15.6 (13.9–19.0)13.1 (12.1–13.9)0.004
AUC0–24 ≥ 5638 (40)12 (11.2)0.002
Concomitant use of nephrotoxinsc18 (90.0)53 (49.5)0.001
Outcomes
Overall 30-day mortality6 (30.0)16 (15)0.098
  • a Data are presented as numbers (percentages) of cases unless otherwise stated. Asterisks indicate vancomycin parameters determined at steady state. Cmin, minimum concentration of drug.

  • b Source of bacteremia grouped into one of three groups based on overall mortality risk: low risk, line-related bacteremia (n = 35) and other sources (n = 3); intermediate risk, bone and joint (n = 14), skin and soft tissue infections (n = 20), deep abscess (n = 4), and no identified focus (n = 12); high risk, infective endocarditis (n = 12), pneumonia (n = 19), abdominal sources (n = 6), and nonendocarditis vascular sources (n = 2).

  • c Any of the following agents were regarded as nephrotoxins: aminoglycosides, amphotericin B, angiotensin-converting enzyme inhibitor, angiotensin receptor blocker, colistin, contrast dye, cyclosporine, cisplatin, diuretics, nonsteroidal anti-inflammatory drugs, tacrolimus, and vasopressor medications.