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Biopsy-proven vancomycin-induced acute kidney injury: a case report and literature review

Overview of attention for article published in BMC Nephrology, March 2018
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Title
Biopsy-proven vancomycin-induced acute kidney injury: a case report and literature review
Published in
BMC Nephrology, March 2018
DOI 10.1186/s12882-018-0845-1
Pubmed ID
Authors

Anri Sawada, Kunio Kawanishi, Shohei Morikawa, Toshihiro Nakano, Mio Kodama, Mitihiro Mitobe, Sekiko Taneda, Junki Koike, Mamiko Ohara, Yoji Nagashima, Kosaku Nitta, Takahiro Mochizuki

Abstract

Vancomycin is the first-line antibiotic for methicillin-resistant Staphylococcus aureus and coagulase-negative strains. The risk of vancomycin-induced acute kidney injury increases with plasma vancomycin levels. Vancomycin-induced acute kidney injury is histologically characterized by acute interstitial nephritis and/or acute tubular necrosis. However, only 12 biopsy-proven cases of vancomycin-induced acute kidney injury have been reported so far, as renal biopsy is rarely performed for such cases. Current recommendations for the prevention or treatment of vancomycin-induced acute kidney injury are drug monitoring of plasma vancomycin levels using trough level and drug withdrawal. Oral prednisone and high-flux haemodialysis have led to the successful recovery of renal function in some biopsy-proven cases. We present the case of a 41-year-old man with type 1 diabetes mellitus, who developed vancomycin-induced acute kidney injury during treatment for Fournier gangrene. His serum creatinine level increased to 1020.1 μmol/L from a baseline of 79.6 μmol/L, and his plasma trough level of vancomycin peaked at 80.48 μg/mL. Vancomycin discontinuation and frequent haemodialysis with high-flux membrane were immediately performed following diagnosis. Renal biopsy showed acute tubular necrosis and focal acute interstitial nephritis, mainly in the medullary rays (medullary ray injury). There was no sign of glomerulonephritis, but mild diabetic changes were detected. He was discharged without continuing haemodialysis (serum creatinine level, 145.0 μmol/L) 49 days after initial vancomycin administration. This case suggests that frequent haemodialysis and renal biopsy could be useful for the treatment and assessment of vancomycin-induced acute kidney injury, particularly in high-risk cases or patients with other renal disorders.

Twitter Demographics

The data shown below were collected from the profiles of 2 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 13 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 13 100%

Demographic breakdown

Readers by professional status Count As %
Unspecified 5 38%
Student > Master 2 15%
Student > Bachelor 2 15%
Student > Doctoral Student 2 15%
Student > Postgraduate 1 8%
Other 1 8%
Readers by discipline Count As %
Unspecified 5 38%
Medicine and Dentistry 3 23%
Agricultural and Biological Sciences 2 15%
Biochemistry, Genetics and Molecular Biology 1 8%
Nursing and Health Professions 1 8%
Other 1 8%

Attention Score in Context

This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 02 April 2018.
All research outputs
#7,960,393
of 12,745,229 outputs
Outputs from BMC Nephrology
#693
of 1,284 outputs
Outputs of similar age
#161,450
of 273,184 outputs
Outputs of similar age from BMC Nephrology
#1
of 1 outputs
Altmetric has tracked 12,745,229 research outputs across all sources so far. This one is in the 37th percentile – i.e., 37% of other outputs scored the same or lower than it.
So far Altmetric has tracked 1,284 research outputs from this source. They receive a mean Attention Score of 3.3. This one is in the 45th percentile – i.e., 45% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 273,184 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 40th percentile – i.e., 40% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 1 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them