{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T13:05:45Z","timestamp":1769691945401,"version":"3.49.0"},"reference-count":44,"publisher":"S. Karger AG","issue":"2","license":[{"start":{"date-parts":[[2018,1,1]],"date-time":"2018-01-01T00:00:00Z","timestamp":1514764800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"},{"start":{"date-parts":[[2018,1,1]],"date-time":"2018-01-01T00:00:00Z","timestamp":1514764800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nephron"],"published-print":{"date-parts":[[2018]]},"abstract":"<jats:p>&lt;b&gt;&lt;i&gt;Background:&lt;\/i&gt;&lt;\/b&gt; Vancomycin-associated (VA) acute kidney injury (AKI) is being increasingly recognized. A distinct pattern of rapid rise in serum creatinine (sCr) during VA-AKI has occasionally been observed. However, such scenarios remain underreported. &lt;b&gt;&lt;i&gt;Methods:&lt;\/i&gt;&lt;\/b&gt; We conducted an online survey at the American Society of Nephrology Communities forum and reviewed publications of VA-AKI via PubMed or Google searching for cases of precipitous AKI (those with rise in sCr\u00a0\u22651.5 mg\/dL\/day) attributable to vancomycin. &lt;b&gt;&lt;i&gt;Results:&lt;\/i&gt;&lt;\/b&gt; We identified 12 original cases compiled from 6 different hospitals and 4 published cases (&lt;i&gt;n&lt;\/i&gt; = 16; 38% women, age 43.5 \u00b1 16 years, weight 108 \u00b1 23 kg, body mass index 35 \u00b1 7 kg\/m&lt;sup&gt;2&lt;\/sup&gt;) of precipitous AKI observed shortly after large cumulative doses of VA (8.8 \u00b1 5 g). The median steepest 24-h rise in sCr was 2.6 mg\/dL (range 1.5\u20133.5 mg\/dL) and the slope of the initial 48-h sCr rise was greater than that of a control AKI (non-VA, &lt;i&gt;n&lt;\/i&gt; = 48) group (2.03 \u00b1 0.1 vs. 0.62 \u00b1 0.0 mg\/dL\/day; &lt;i&gt;p&lt;\/i&gt; &amp;#x3c; 0.0001). The steep rise in sCr in the VA-AKI was not accompanied by anuria. Overt rhabdomyolysis was absent in all cases. Further, in 3 precipitous VA-AKI cases, simultaneous serum cystatin C values did not rise precipitously, suggesting that the reductions in glomerular filtration rate were overestimated by the sCr increase. &lt;b&gt;&lt;i&gt;Conclusions:&lt;\/i&gt;&lt;\/b&gt; VA-AKI can manifest with a precipitous rise in sCr shortly after a high cumulative dose of vancomycin. True toxic tubular injury overrepresented by the sCr rise is postulated.<\/jats:p>","DOI":"10.1159\/000487149","type":"journal-article","created":{"date-parts":[[2018,4,27]],"date-time":"2018-04-27T21:01:36Z","timestamp":1524862896000},"page":"131-142","source":"Crossref","is-referenced-by-count":11,"title":["Vancomycin-Associated Acute Kidney Injury with a Steep Rise in Serum 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