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We report a 75\u2010year\u2010old woman with previously normal renal function, who developed acute kidney injury (<jats:styled-content style=\"fixed-case\">AKI<\/jats:styled-content>) secondary to biopsy\u2010proven acute tubular necrosis and acute interstitial nephritis after<jats:styled-content style=\"fixed-case\">ACS<\/jats:styled-content>placement containing tobramycin and vancomycin. Peak tobramycin level measured 25.3 mcg\/mL, the highest value reported in the literature after<jats:styled-content style=\"fixed-case\">ACS<\/jats:styled-content>placement. Intermittent hemodialysis was initiated with subsequent full recovery of renal function. This paper reviews the published literature regarding the accumulation, toxicity and removal dynamics of aminoglycoside (<jats:styled-content style=\"fixed-case\">AG<\/jats:styled-content>) antibiotics and vancomycin in renal patients. Obtaining serum<jats:styled-content style=\"fixed-case\">AG<\/jats:styled-content>level should be strongly considered in patients experiencing<jats:styled-content style=\"fixed-case\">AKI<\/jats:styled-content>after<jats:styled-content style=\"fixed-case\">ACS<\/jats:styled-content>. Renal replacement therapy may assist in reducing toxic<jats:styled-content style=\"fixed-case\">AG<\/jats:styled-content>levels.<\/jats:p>","DOI":"10.1111\/sdi.12639","type":"journal-article","created":{"date-parts":[[2017,8,1]],"date-time":"2017-08-01T01:44:46Z","timestamp":1501551886000},"page":"88-93","source":"Crossref","is-referenced-by-count":17,"title":["Aminoglycoside impregnated cement spacer precipitating acute kidney injury requiring hemodialysis"],"prefix":"10.1111","volume":"31","author":[{"given":"Sohail Abdul","family":"Salim","sequence":"first","affiliation":[{"name":"Division of Nephrology Department of Internal Medicine University of Mississippi Medical Center Jackson MS USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Everitt","sequence":"additional","affiliation":[{"name":"Division of Nephrology Department of Internal Medicine University of Mississippi Medical Center Jackson MS 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