Abstract: PO0081
Risk of Nephrotoxicity in Patients Receiving Concomitant Vancomycin and Intravenous Contrast Media
Session Information
- AKI Clinical, Outcomes, and Trials - 1
October 22, 2020 | Location: On-Demand
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 102 AKI: Clinical, Outcomes, and Trials
Authors
- Hsu, Amy, University of California Irvine, Irvine, California, United States
- Lee, Helen S., University of California Irvine, Irvine, California, United States
- Lee, Benjamin, University of California Irvine, Irvine, California, United States
- Kalantar-Zadeh, Kamyar, University of California Irvine, Irvine, California, United States
- Hanna, Ramy Magdy, University of California Irvine, Irvine, California, United States
- Baje, Mark A., University of California Irvine, Irvine, California, United States
Background
Contrast-induced nephropathy (CIN) has been described as a significant cause of acute kidney injury (AKI). Although the nephrotoxic potential of vancomycin has widely been published, the contributory effect of these two agents towards AKI has not been fully elucidated. We sought to better define this interaction.
Methods
The primary objective of this retrospective cohort study was to compare the incidence of AKI among adult patients receiving vancomycin (VAN) and vancomycin plus IV contrast (VC) within 96 hours of administration.Secondary outcomes included time to AKI development, hospital length of stay (LOS), and 30-day, all-cause mortality. A logistic regression was performed to identify potential risk factors for AKI among vancomycin-treated patients.
Results
A total of 114 patients receiving ≥ 4 consecutive days of vancomycin were included, 50 receiving VAN and 64 receiving VC. An additional 50 patients who received IV contrast alone were independently assessed for CIN, of which only 3 (6%) developed AKI. In the unadjusted analysis, no statistically significant difference in the rate of AKI (10% vs 20.3%; p=0.13), days until AKI (6 days vs 5 days; p=0.37), highest vancomycin trough (16.7 vs 17.8; p=0.62), and hospital LOS (7.5 days vs 8 days; p=0.62) were found between VAN and VC patients. The addition of IV contrast to vancomycin was not an independent risk factor for AKI after adjusting for relevant confounders (aOR 1.65; 95% CI, 0.48-5.65; p=0.42).
Conclusion
The addition of IV contrast was not associated with an increased risk of AKI in vancomycin-treated patients. The incidence of CIN was rare.