129: Identification of Factors Associated With Vancomycin-Induced Acute Kidney Injury: An Analysis Using a Common Data Model

Statement of Purpose, Innovation or Hypothesis: Predictors for vancomycin-induced acute kidney injury (AKI) include high daily vancomycin dosages, concurrent use of nephrotoxic drugs, and pre-existing kidney disease. However, the results of previous studies have been inconsistent. Thus, we aimed to identify the predictors of vancomycin-induced AKI using the Observational Medical Outcome Partnership common data model. In addition, we compared the pharmacokinetic parameters of vancomycin between patients with AKI and those without AKI.

Description of Methods & Materials: Among patients who received vancomycin from January 1^st, 2012 to May 31^st, 2022, 1,462 tested positive for Staphylococcus aureus infection and had susceptibility test results to oxacillin. After excluding patients without vancomycin or baseline serum creatinine levels, 116 patients were included in the final dataset. Up to the third measured vancomycin concentration was collected for each patient. Logistic regression models were used to estimate the odds ratio and 95% confidence interval for each variable associated with vancomycin-induced AKI.

Data & Results: High baseline serum creatinine levels, intensive care unit admission, and concurrent renal disorders were significantly associated with vancomycin-induced AKI. Although high trough levels or area under the curve (AUC) values were not significantly associated with vancomycin-induced AKI, both were significantly higher in patients with AKI than in those without at the second vancomycin concentration measurement. The proportion of patients with trough levels >20 mg/L was higher in patients with AKI than in those without at the third measurement.

Interpretation, Conclusion or Significance: This retrospective analysis revealed that underlying renal disease and intensive care unit admission are more significantly associated with vancomycin-induced AKI than vancomycin pharmacokinetic parameters or dosage. This result can be ascribed to the fact that individual dosages are adjusted based on the routine monitoring of vancomycin concentrations in clinical settings. Along with further prospective studies, our findings may help develop strategies for reducing the incidence of vancomycin-induced AKI.

Disclosures: This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korean government (Ministry of Science and ICT (MSIT)) (NRF–2022R1F1A1064828).

Citations/References: 1. Park K, Cho M, Song M, Yoo S, Baek H, Kim S, Kim K. Exploring the potential of OMOP common data model for process mining in healthcare. PLoS One 2023;18(1):e0279641.

Additional Information/Authors: None