biopsy-proven acute tubular necrosis due to vancomycin toxicity由于万古霉素毒性biopsy-proven急性肾小管坏死.pdfVIP

SAGE-Hindawi Access to Research International Journal of Nephrology Volume 2011, Article ID 436856, 4 pages doi:10.4061/2011/436856 Case Report Biopsy-Proven Acute Tubular Necrosis due to Vancomycin Toxicity Farheen Shah-Khan,1 Marc H. Scheetz,2, 3 and Cybele Ghossein1 1 Division of Nephrology, Northwestern Memorial Hospital, Chicago, IL 60611, USA 2 Department of Pharmacy Practice, College of Pharmacy, Midwestern University Chicago, Downers Grove, IL 60515, USA 3 Department of Pharmacy, Northwestern Memorial Hospital, Chicago, IL 60611, USA Correspondence should be addressed to Cybele Ghossein, c-ghossein@ Received 28 February 2011; Accepted 26 April 2011 Academic Editor: Franca Anglani Copyright © 2011 Farheen Shah-Khan et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Vancomycin (VAN) has been associated with acute kidney injury (AKI) since it has been put into clinical use in the 1950’s. Early reports of AKI were likely linked to the impurities of the VAN preparation. With the advent of the more purified forms of VAN, the incidence of AKI related to VAN were limited to acute interstitial nephritis (AIN) or as a potentiating agent to other nephrotoxins such as Aminoglycosides. VAN as the sole etiologic factor for nephrotoxic acute tubular necrosis (ATN) has not been described. Here, we report a case of biopsy-proven ATN resulting from VAN. 1. Case estimated at approximately 0.6 L/kg of actual body weight and a VAN clearance estimated to be at least