Variations in vancomycin trough concentrations and associated risk factors in patients with end-stage renal dis-ease

CHEN Xin-lei; LI Hong-ru; ZHENG Shuan; XI Ning; ZHANG Yi

doi:10.13820/j.cnki.gdyx.20242395

Abstract：Objective To analyze the variation in vancomycin trough concentrations and identify associated risk factors in patients with end-stage renal disease(ESRD).Methods A total of 100 ESRD patients treated with vanco-mycin from February 2022 to February 2023 were retrospectively included.The steady-state trough concentration of van-comycin was measured 30 minutes before the fifth dose.Clinical data were collected and subjected to univariate and multi-variate logistic regression analysis to determine the main risk factors affecting vancomycin trough concentration levels.Results A total of 235 vancomycin trough concentration measurements were obtained across the 100 patients,with an aver-age concentration of(17.24±3.06)mg/L.Among them,24 patients(24.00％)had trough concentrations＜10 mg/L,60 patients(60.00％)had concentrations between 10-20 mg/L,and 16 patients(16.00％)had concentrations＞20 mg/L.Univariate analysis revealed that trough concentration variations were not significantly associated with gender,body mass index(BMI),cardiovascular disease,hypertension,creatinine clearance rate,or length of hospital stay(P＞0.05),but were significantly associated with age,primary disease,loading dose,timing of administration,dosing fre-quency,and maintenance dose(P＜0.05).Multivariate logistic regression identified age,primary disease,dosing fre-quency,maintenance dose,loading dose,and timing of administration as independent risk factors for vancomycin trough concentration variation(P＜0.05).Conclusion Patients with ESRD exhibit high interindividual variability in vancomy-cin sensitivity.Careful control of vancomycin dosing is essential,and continuous monitoring of trough concentrations is crucial to ensure safe and effective therapy.