{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T16:02:08Z","timestamp":1791820928682,"version":"4.3.4"},"reference-count":35,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2023,4,17]],"date-time":"2023-04-17T00:00:00Z","timestamp":1681689600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Vancomycin has been widely used in the last six decades to treat methicillin-resistant <jats:italic>S<\/jats:italic>. <jats:italic>aureus<\/jats:italic> (MRSA) and other resistant gram-positive infections. The risk of vancomycin toxicity increases with the utilization of higher doses while treating the resistant form of bacterial infections. Nephrotoxicity is one of the major complications reported to be a hinderance in the prognosis of vancomycin therapy.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Objectives<\/jats:title>\n<jats:p>This hospital-based study aimed to highlight the influence of vancomycin on renal function with special emphasis on identifying the predictors and augmenting factors for nephrotoxicity.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Methodology<\/jats:title>\n<jats:p>A cross-sectional, unicentric, hospital-based study was conducted at King Fahad Specialist Hospital (KFSH) in Qassim region in Saudi Arabia (KSA). It included 319 hospitalized patients who received vancomycin at intermittent doses (15 to 30 mg\/kg IV per day) based on the diseased state. Data regarding vancomycin dose, frequency, duration and data of renal function tests and type of admission were analysed to evaluate their influence on the renal function using parameters such as blood urea, serum creatinine levels and creatinine clearance. One-way ANOVA and Spearman correlation test were used in the analysis of data.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Results<\/jats:title>\n<jats:p>Both male and female patients treated with vancomycin had significantly (p&lt;0.05) elevated blood urea and serum creatinine levels compared to baseline levels while creatinine clearance was non-significantly varied. Increasing age, increasing body weight, higher vancomycin dose and trough levels, increased vancomycin frequency and duration, critically ill patients and site of infection were factors associated with significant (p&lt;0.05) increases in blood urea and serum creatinine levels with reduction in creatinine clearance.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec005\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Data suggested that vancomycin treatment reduced the renal function in patients and indicated its association with several predictors and confounding factors. The findings of the study might assist in identifying the patients under risk from the vancomycin-induced nephrotoxicity and in designing the preventive strategies to reduce such complications.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0284223","type":"journal-article","created":{"date-parts":[[2023,4,17]],"date-time":"2023-04-17T17:30:13Z","timestamp":1681752613000},"page":"e0284223","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":8,"title":["The influence of vancomycin on renal functions, the predictors and associated factors for nephrotoxicity"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7719-9308","authenticated-orcid":true,"given":"Waleed M.","family":"Altowayan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7087-2822","authenticated-orcid":true,"given":"Mugahid A.","family":"Mobark","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdulmajed","family":"ALharbi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdullah Ali","family":"Alduhami","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Syed Imam","family":"Rabbani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,4,17]]},"reference":[{"issue":"6","key":"pone.0284223.ref001","doi-asserted-by":"crossref","first-page":"1107","DOI":"10.1016\/j.clinthera.2007.06.014","article-title":"A retrospective analysis of possible renal toxicity associated with vancomycin in patients with health care-associated methicillin-resistant Staphylococcus aureus pneumonia.","volume":"29","author":"MN Jeffres","year":"2007","journal-title":"Clinical therapeutics."},{"issue":"1","key":"pone.0284223.ref002","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1093\/jac\/dkn080","article-title":"Risk factors for nephrotoxicity associated with continuous vancomycin infusion in outpatient parenteral antibiotic therapy","volume":"62","author":"PR Ingram","year":"2008","journal-title":"Journal of antimicrobial chemotherapy"},{"issue":"3","key":"pone.0284223.ref003","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1086\/600877","article-title":"Vancomycin therapeutic guidelines: a summary of consensus recommendations from the infectious diseases Society of America, the American Society of Health-System Pharmacists, and the Society of Infectious Diseases Pharmacists","volume":"49","author":"MJ Rybak","year":"2009","journal-title":"Clinical infectious diseases"},{"issue":"6","key":"pone.0284223.ref004","doi-asserted-by":"crossref","first-page":"1361","DOI":"10.1093\/cid\/ciaa303","article-title":"Therapeutic monitoring of vancomycin for serious methicillin-resistant Staphylococcus aureus infections: a revised consensus guideline and review by the American Society of Health-System Pharmacists, the Infectious Diseases Society of America, the Pediatric Infectious Diseases Society, and the Society of Infectious Diseases Pharmacists","volume":"71","author":"MJ Rybak","year":"2020","journal-title":"Clinical Infectious Diseases"},{"issue":"13","key":"pone.0284223.ref005","first-page":"4840","article-title":"Factors influencing the vancomycin trough level in patients admitted at King Fahad Specialist Hospital, Qassim, KSA.","volume":"26","author":"WM Altowayan","year":"2022","journal-title":"European Review for Medical and Pharmacological Sciences."},{"issue":"Supplement_1","key":"pone.0284223.ref006","doi-asserted-by":"crossref","first-page":"S35","DOI":"10.1086\/491712","article-title":"The pharmacokinetic and pharmacodynamic properties of vancomycin","volume":"42","author":"MJ Rybak","year":"2006","journal-title":"Clinical Infectious Diseases"},{"key":"pone.0284223.ref007","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1080\/08998280.2016.11929491","article-title":"Acute renal failure due to vancomycin toxicity in the setting of unmonitored vancomycin infusion","volume":"29","author":"S. 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