Rapid removal of vancomycin by continuous veno-venous hemofiltration

Mehul Shah, Raymond Quigley

Research output: Contribution to journalArticle

9 Scopus citations

Abstract

We describe a 14-year-old girl with staphylococcal (coagulase-negative) ventriculo-peritoneal shunt infection, who developed oliguric acute renal failure and was found to have a serum vancomycin concentration of 250 μg/ml. Since only about 10%-50% of vancomycin is bound to protein in blood, we employed continuous veno-venous hemofiltration (CVVH) with a high ultrafiltration rate (1800 ml/h) for increased convective clearance to remove vancomycin, which may have contributed to the acute renal failure. At the end of 38 h of CVVH, the vancomycin concentration had decreased in an exponential manner to 27 μg/ml. Over the subsequent 3-4 days, her renal function improved and the vancomycin concentration decreased further to < 5 μg/ml. In conclusion, we believe that a high serum vancomycin concentration may be nephrotoxic and demonstrate that CVVH can be used effectively to remove vancomycin in children with acute renal failure.

Original languageEnglish (US)
Pages (from-to)912-915
Number of pages4
JournalPediatric Nephrology
Volume14
Issue number10-11
DOIs
StatePublished - Sep 1 2000

Keywords

  • Acute renal failure
  • Continuous veno-venous hemofiltration
  • Nephrotoxicity
  • Vancomycin

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Nephrology

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