Concomitant Use of Multiple Nephrotoxins Including Renal Hypoperfusion Medications Causes Vancomycin-Associated Nephrotoxicity : Combined Retrospective Analyses of Two Real-World Databases

• Material Type: 博士論文
• Title: Concomitant Use of Multiple Nephrotoxins Including Renal Hypoperfusion Medications Causes Vancomycin-Associated Nephrotoxicity : Combined Retrospective Analyses of Two Real-World Databases
• Author/Editor: Bando, Takashi; Chuma, Masayuki; Hamano, Hirofumi; Niimura, Takahiro; Okada, Naoto; Kondo, Masateru; Izumi, Yuki; Ishida, Shunsuke; Yoshioka, Toshihiko; Asada, Mizuho; Zamami, Yoshito; Takechi, Kenshi; Goda, Mitsuhiro; Miyata, Koji; Yagi, Kenta; Izawa-Ishizawa, Yuki; Azuma, Momoyo; Yanagawa, Hiroaki; Tasaki, Yoshikazu; Ishizawa, Keisuke
• Author Heading: Bando, Takashi; Chuma, Masayuki; Hamano, Hirofumi; Niimura, Takahiro; Okada, Naoto; Kondo, Masateru; Izumi, Yuki; Ishida, Shunsuke; Yoshioka, Toshihiko; Asada, Mizuho; Zamami, Yoshito; Takechi, Kenshi; Goda, Mitsuhiro; Miyata, Koji; Yagi, Kenta; Izawa-Ishizawa, Yuki; Azuma, Momoyo; Yanagawa, Hiroaki; Tasaki, Yoshikazu; Ishizawa, Keisuke
• Publication, Distribution, etc.: Okayama University Medical School
• Publication Date: 2023-12
• Publication Date (W3CDTF): 2023-12
• Alternative Title: 腎血流量を低下させる薬剤を含む複数の腎毒性を有する薬の併用はバンコマイシン関連腎障害を引き起こす : 2つのリアルワールドデータベースを組み合わせた後方視的研究; Nephrotoxicity with VCM and Nephrotoxins
• Periodical title: Acta Medica Okayama
• No. or year of volume/issue: 77 6
• Volume: 77
• Issue: 6
• Pages: 595-605
• ISSN (Periodical Title): ISSN : 0386-300X
• Degree grantor/type: 徳島大学
• Date Granted: 2023-10-26
• Dissertation Number: 甲第3761号
• Degree Type: 博士（医学）
• Text Language Code: eng
• Subject Heading: vancomycin-associated nephrotoxicity; polypharmacy; nephrotoxin; spontaneous adverse event reporting database; electronic medical records
• Target Audience: 一般
• Note (General): There is a growing concern about the relationship between vancomycin-associated nephrotoxicity (VAN) and concomitant use of nephrotoxins. We examined this relationship by combined retrospective analyses of two real-world databases. Initially, the FDA Adverse Event Reporting System (FAERS) was analyzed for the effects of concomitant use of one or more nephrotoxins on VAN and the types of combinations of nephrotoxins that exacerbate VAN. Next, electronic medical records (EMRs) of patients who received vancomycin (VCM) at Tokushima University Hospital between January 2006 and March 2019 were examined to confirm the FAERS analysis. An elevated reporting odds ratio (ROR) was observed with increases in the number of nephrotoxins administered (VCM + one nephrotoxin, adjusted ROR (95% confidence interval [CI]) 1.67 [1.51–1.85]; VCM + ≥ 2 nephrotoxins, adjusted ROR [95% CI] 1.54 [1.37–1.73]) in FAERS. EMRs analysis showed that the number of nephrotoxins was associated with higher incidences of VAN [odds ratio: 1.99; 95% CI: 1.42–2.78]. Overall, concomitant use of nephrotoxins was associated with an increased incidence of VAN, especially when at least one of those nephrotoxins was a renal hypoperfusion medication (furosemide, non-steroidal anti-inflammatory drugs, and vasopressors). The concomitant use of multiple nephrotoxins, especially including renal hypoperfusion medication, should be avoided to prevent VAN.
• Access Restrictions: インターネット公開
• Rights (production): CopyrightⒸ 2023 by Okayama University Medical School
• Related Material (DOI): 10.18926/AMO/66151
• Data Provider (Database): 国立情報学研究所 : 学術機関リポジトリデータベース（IRDB）（機関リポジトリ）; https://irdb.nii.ac.jp
• Original Data Provider (Database): 徳島大学 : 徳島大学機関リポジトリ

Table of Contents

http://repo.lib.tokushima-u.ac.jp/files/public/11/118742/20240112150258894475/k3761_abstract.pdf fulltext

http://repo.lib.tokushima-u.ac.jp/files/public/11/118742/20240112150258982831/k3761_review.pdf fulltext

http://repo.lib.tokushima-u.ac.jp/files/public/11/118742/20240112150259234295/k3761_fulltext.pdf fulltext