中国临床药学杂志2026，Vol.35Issue(4)：289-294,6.DOI:10.19577/j.1007-4406.2026.04.001
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
Clinical characteristics and risk factors analysis of vancomycin-associated acute kidney injury in obese patients
摘要
Abstract
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.关键词
万古霉素/急性肾损伤/肥胖患者/危险因素/肾功能转归Key words
vancomycin/acute kidney injury/obese patients/risk factors/renal function outcomes分类
医药卫生引用本文复制引用
张颖,王玉珠,左成淳,李然宜,茅天笑,吕迁洲,潘坤明,李晓宇..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[J].中国临床药学杂志,2026,35(4):289-294,6.基金项目
国家自然科学基金项目(编号82204520) （编号82204520）
上海市卫生健康委员会科研项目(编号20244Y0101) （编号20244Y0101）
上海市申康医院发展中心市级医院诊疗技术推广及优化管理项目(编号SHDC22024203) （编号SHDC22024203）
上海市"医苑新星"青年医学人才培养资助计划(编号SHWSRS[2023]_106) （编号SHWSRS[2023]_106）
