肥胖患者万古霉素相关急性肾损伤的临床特征及危险因素OA

AIM To explore the current status and risk factors of vancomycin-associated acute kidney injury(AKI)in obese patients and analyze its clinical outcomes,providing evidence for rational drug use.METHODS A retrospective analysis was conducted on obese patients(BMI≥28.0 kg·m-2)treated with vancomycin at our hospital from January 2016 to January 2023.Demographic information,hospitalization details,laboratory data,comorbidities,and medication use were collected.Patients were divided into AKI and non-AKI groups based on the occurrence of vancomycin-associated AKI.Multivariate logistic regression was used to analyze the risk factors for vancomycin-associated AKI and related factors influencing renal function recovery.RESULTS A total of 516 patients were included,with males accounting for 66.5％and a median age of 59 years.AKI occurred in 77 patients,with an incidence rate of 14.9％.Multivariable logistic regression showed that vancomycin treatment duration(OR=1.074,P=0.000),hypertension(OR=2.042,P=0.006),concurrent use of vasopressors(OR=2.696,P=0.004),and ICU admission(OR=1.794,P=0.026)were independent risk factors for vancomycin-associated AKI.Further analysis revealed that ICU admission(OR=3.433,P=0.022)and contrast agent use(OR=5.908,P=0.034)significantly promoted renal function improvement.CONCLUSION For obese patients with underlying diseases,prolonged vancomycin treatment or ICU admission,enhanced therapeutic drug monitoring is necessary to optimize treatment safety.