The effect of urine volume on the blood concentration and intraperitoneal administration of vancomycin dose in patients with peritoneal dialysis associated peritonitis
The effect of urine volume on the blood concentration and intraperitoneal administration of vancomycin dose in patients with peritoneal dialysis associated peritonitis
Objective To explore the effect of 24-hour urine volume on the blood concentration and dosage of vancomycin in patients with peritoneal dialysis associated peritonitis.Methods Using a retrospective study method,a total 41 eligible patients with per-itoneal dialysis related peritonitis treated empirical or on target with vancomycin were screen.The patients were divided into 16 cases in no urine group(urine volume<100 ml),15 cases in the oliguria group(100 mL≤urine volume<400 mL),and 10 cases in the pres-ence of urine group(urine volume ≥400 mL)based on 24 h urine volume.The general data of the patients were recorded,24-hour u-rine volume,eGFR,vancomycin blood concentration,and the dose of vancomycin administered when the concentration reached the stand-ard were recorded.The effects of urine volume on vancomycin blood concentration and the dose of vancomycin administered were ana-lyzed.Results A total of 65 patients with peritoneal dialysis-associated peritonitis were collected,41 patients data were included in the study.The vancomycin blood concentrations(trough concentrations)in three groups of patients were(19.18±10.38)mg/L,(12.97±2.08)mg/L and(11.30±3.78)mg/L respectively.Compared with the group without urine Vancomycin blood concentration was signif-icantly lower in the oliguria group and the group with urine compared to the group without urine(P<0.05).Vancomycin blood concen-tration was achieved at(4.27±1.09)mg/(kg·d-1)、(4.46±0.69)mg/(kg·d-1),(4.92±1.07)mg/(kg·d-1)in the three group.a higher dosage of vancomycin was administered at the vancomycin blood concentration level in the group with urine compared with that in the group without urine(P<0.05).Pearson correlation analysis showed that 24 h urine volume was negatively correlated with vancomycin concentration(r=-0.462,P<0.05).Conclusion 24-hour urine output could affect the blood concentration and dos-age of vancomycin in patients with peritoneal dialysis associated peritonitis.Residual renal function should be considered when using van-comycin in this population.
关键词
24/h尿量/腹膜透析相关性腹膜炎/万古霉素/残余肾功能
Key words
24-hour urine output/Peritoneal dialysis associated peritonitis/Vancomycin/Residual kidney function