Biopsy-Proven Acute Tubular Necrosis due to Vancomycin Toxicity英文文献资料.docVIP

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Biopsy-Proven Acute Tubular Necrosis due to Vancomycin Toxicity英文文献资料.doc

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Biopsy-Proven Acute Tubular Necrosis due to Vancomycin Toxicity英文文献资料

SAGE-HindawiAccesstoResearch InternationalJournalofNephrology Volume2011,ArticleID436856,4pages doi:10.4061/2011/436856 CaseReport Biopsy-ProvenAcuteTubularNecrosisdueto VancomycinToxicity FarheenShah-Khan, 1MarcH.Scheetz,2,3andCybeleGhossein1 1 2 3 DivisionofNephrology,NorthwesternMemorialHospital,Chicago,IL60611,USA DepartmentofPharmacyPractice,CollegeofPharmacy,MidwesternUniversityChicago,DownersGrove,IL60515,USA DepartmentofPharmacy,NorthwesternMemorialHospital,Chicago,IL60611,USA CorrespondenceshouldbeaddressedtoCybeleGhossein,c-ghossein@ Received28February2011;Accepted26April2011 AcademicEditor:FrancaAnglani Copyright?2011FarheenShah-Khanetal.ThisisanopenaccessarticledistributedundertheCreativeCommonsAttribution License,whichpermitsunrestricteduse,distribution,andreproductioninanymedium,providedtheoriginalworkisproperly cited. Vancomycin(VAN)hasbeenassociatedwithacutekidneyinjury(AKI)sinceithasbeenputintoclinicaluseinthe1950’s.Early reportsofAKIwerelikelylinkedtotheimpuritiesoftheVANpreparation.Withtheadventofthemorepuri?edformsofVAN,the incidenceofAKIrelatedtoVANwerelimitedtoacuteinterstitialnephritis(AIN)orasapotentiatingagenttoothernephrotoxins suchasAminoglycosides.VANasthesoleetiologicfactorfornephrotoxicacutetubularnecrosis(ATN)hasnotbeendescribed. Here,wereportacaseofbiopsy-provenATNresultingfromVAN. 1.Case estimated at approximately 0.6L/kg of actual body weight and a VAN clearance estimated to be at least 120mL/min R. H. is a 23-year-old male with a history of childhood [3], the patient was expected to achieve an initial VAN trough of approximately 8mg/L with steady state troughs above10mg/Lwithadosingschemeof2000mggivenevery 12 hours. As pharmacokinetic estimates in patients above theiraveragebodyweightexhibitsubstantialvariability,the patient was initiated on the aforementioned dose with a measuredVANtroughplannedantecedenttothefourthdose (to capture steady-state concentrations). Goal troughs and monitoringschemeswereperformedaccordingtonational V