Brianne M Ritchie1, Beth A Hirning2, Craig A Stevens2, Steven A Cohen3, Jeremy R DeGrado2. 1. a Department of Pharmacy , Mayo Clinic , Rochester , MN , USA. 2. b Department of Pharmacy Services , Brigham and Women's Hospital , Boston , MA , USA. 3. c Department of Kinesiology, Health Studies Program , University of Rhode Island , Kingston , RI , USA.
Abstract
BACKGROUND: Acute kidney injury (AKI) is a common complication of endocarditis. OBJECTIVE: To determine risk factors for the development of AKI in patients treated for endocarditis. METHODS: This single centre, retrospective univariate and multivariate analysis to determine risk factors for the development of AKI included patients diagnosed with endocarditis between January 2009 and October 2013. RESULTS: Of 211 included patients, a total of 84 (39.8%) patients developed AKI. We identified multiple independent variables associated with the development of AKI, including: age ≥ 65 years, presence of hardware, chronic kidney disease, AKI on admission, infection with Staphylococcus spp, receipt of nafcillin or oxacillin or aminoglycoside and nafcillin or oxacillin or aminoglycoside and vancomycin, vancomycin trough level ≥ 20.0 mcg/ml, aminoglycoside total daily dose reduction, duration of vancomycin exceeding three days, receipt of loop diuretic or more than three concomitant nephrotoxins and duration of loop diuretic or non-steroidal anti-inflammatory drug therapy exceeding seven days. CONCLUSIONS: In patients treated for endocarditis, multiple risk factors for AKI were identified. Prospective studies are needed to evaluate these variables for causation of AKI in patients treated for endocarditis.
BACKGROUND:Acute kidney injury (AKI) is a common complication of endocarditis. OBJECTIVE: To determine risk factors for the development of AKI in patients treated for endocarditis. METHODS: This single centre, retrospective univariate and multivariate analysis to determine risk factors for the development of AKI included patients diagnosed with endocarditis between January 2009 and October 2013. RESULTS: Of 211 included patients, a total of 84 (39.8%) patients developed AKI. We identified multiple independent variables associated with the development of AKI, including: age ≥ 65 years, presence of hardware, chronic kidney disease, AKI on admission, infection with Staphylococcus spp, receipt of nafcillin or oxacillin or aminoglycoside and nafcillin or oxacillin or aminoglycoside and vancomycin, vancomycin trough level ≥ 20.0 mcg/ml, aminoglycoside total daily dose reduction, duration of vancomycin exceeding three days, receipt of loop diuretic or more than three concomitant nephrotoxins and duration of loop diuretic or non-steroidal anti-inflammatory drug therapy exceeding seven days. CONCLUSIONS: In patients treated for endocarditis, multiple risk factors for AKI were identified. Prospective studies are needed to evaluate these variables for causation of AKI in patients treated for endocarditis.