Usefulness of serum cystatin C to determine the dose of vancomycin in critically ill patients

Akio Suzuki, Yoshinori Imanishi, Shiho Nakano, Takashi Niwa, Tomofumi Ohmori, Kunihiro Shirai, Shozo Yoshida, Nobuyuki Furuta, Masao Takemura, Hiroyasu Ito, Ichiro Ieiri, Mitsuru Seishima, Shinji Ogura, Yoshinori Itoh

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Objectives Serum creatinine (Scr) is not a reliable marker of renal function in critically ill patients because of an enhancement of protein catabolism, which makes it difficult to adjust the dosage of renally eliminated drugs such as antibiotics. This study aimed to investigate whether serum cystatin C (Scys-C) could be used as a reliable marker of renal function. Methods We investigated whether Scys-C was a reliable marker of renal function in 56 critically ill patients. Subsequently, the usefulness of Scys-C to determine the initial loading and the maintenance dose of vancomycin was examined in 18 patients. Crea- tinine clearance (Ccr) was assessed from Scr and creatinine in urine collected over 24 h (24-h Ccr). Key findings There was a good correlation between 24-h Ccr and 1/Scys-C (r2 = 0.616), whereas less marked correlation was observed between 24-h Ccr and 1/Scr (r2 = 0.221). On the other hand, vancomycin concentration was predicted from population pharmacokinetic parameters based on a two-compartment linear model. There were significant correlations between real trough concentrations of vancomycin and the values predicted from Scys-C using various equations (r 2 = 0.416-0.488), while less pronounced relationships were observed between real concentrations and the values predicted from Scr (r2 = 0.134-0.187). Conclusions These findings suggest that Scys-C is a reliable marker reflecting renal function in critically ill patients and is applicable to determine the initial loading dose as well as the maintenance dose of vancomycin.

Original languageEnglish
Pages (from-to)901-907
Number of pages7
JournalJournal of Pharmacy and Pharmacology
Volume62
Issue number7
DOIs
Publication statusPublished - Jul 1 2010

Fingerprint

Cystatin C
Vancomycin
Critical Illness
Creatinine
Serum
Kidney
Linear Models
Pharmacokinetics
Urine
Anti-Bacterial Agents

All Science Journal Classification (ASJC) codes

  • Pharmacology
  • Pharmaceutical Science

Cite this

Suzuki, A., Imanishi, Y., Nakano, S., Niwa, T., Ohmori, T., Shirai, K., ... Itoh, Y. (2010). Usefulness of serum cystatin C to determine the dose of vancomycin in critically ill patients. Journal of Pharmacy and Pharmacology, 62(7), 901-907. https://doi.org/10.1211/jpp.62.07.0011

Usefulness of serum cystatin C to determine the dose of vancomycin in critically ill patients. / Suzuki, Akio; Imanishi, Yoshinori; Nakano, Shiho; Niwa, Takashi; Ohmori, Tomofumi; Shirai, Kunihiro; Yoshida, Shozo; Furuta, Nobuyuki; Takemura, Masao; Ito, Hiroyasu; Ieiri, Ichiro; Seishima, Mitsuru; Ogura, Shinji; Itoh, Yoshinori.

In: Journal of Pharmacy and Pharmacology, Vol. 62, No. 7, 01.07.2010, p. 901-907.

Research output: Contribution to journalArticle

Suzuki, A, Imanishi, Y, Nakano, S, Niwa, T, Ohmori, T, Shirai, K, Yoshida, S, Furuta, N, Takemura, M, Ito, H, Ieiri, I, Seishima, M, Ogura, S & Itoh, Y 2010, 'Usefulness of serum cystatin C to determine the dose of vancomycin in critically ill patients', Journal of Pharmacy and Pharmacology, vol. 62, no. 7, pp. 901-907. https://doi.org/10.1211/jpp.62.07.0011
Suzuki, Akio ; Imanishi, Yoshinori ; Nakano, Shiho ; Niwa, Takashi ; Ohmori, Tomofumi ; Shirai, Kunihiro ; Yoshida, Shozo ; Furuta, Nobuyuki ; Takemura, Masao ; Ito, Hiroyasu ; Ieiri, Ichiro ; Seishima, Mitsuru ; Ogura, Shinji ; Itoh, Yoshinori. / Usefulness of serum cystatin C to determine the dose of vancomycin in critically ill patients. In: Journal of Pharmacy and Pharmacology. 2010 ; Vol. 62, No. 7. pp. 901-907.
@article{e594d7ceaab34ddbaf3391ecac865240,
title = "Usefulness of serum cystatin C to determine the dose of vancomycin in critically ill patients",
abstract = "Objectives Serum creatinine (Scr) is not a reliable marker of renal function in critically ill patients because of an enhancement of protein catabolism, which makes it difficult to adjust the dosage of renally eliminated drugs such as antibiotics. This study aimed to investigate whether serum cystatin C (Scys-C) could be used as a reliable marker of renal function. Methods We investigated whether Scys-C was a reliable marker of renal function in 56 critically ill patients. Subsequently, the usefulness of Scys-C to determine the initial loading and the maintenance dose of vancomycin was examined in 18 patients. Crea- tinine clearance (Ccr) was assessed from Scr and creatinine in urine collected over 24 h (24-h Ccr). Key findings There was a good correlation between 24-h Ccr and 1/Scys-C (r2 = 0.616), whereas less marked correlation was observed between 24-h Ccr and 1/Scr (r2 = 0.221). On the other hand, vancomycin concentration was predicted from population pharmacokinetic parameters based on a two-compartment linear model. There were significant correlations between real trough concentrations of vancomycin and the values predicted from Scys-C using various equations (r 2 = 0.416-0.488), while less pronounced relationships were observed between real concentrations and the values predicted from Scr (r2 = 0.134-0.187). Conclusions These findings suggest that Scys-C is a reliable marker reflecting renal function in critically ill patients and is applicable to determine the initial loading dose as well as the maintenance dose of vancomycin.",
author = "Akio Suzuki and Yoshinori Imanishi and Shiho Nakano and Takashi Niwa and Tomofumi Ohmori and Kunihiro Shirai and Shozo Yoshida and Nobuyuki Furuta and Masao Takemura and Hiroyasu Ito and Ichiro Ieiri and Mitsuru Seishima and Shinji Ogura and Yoshinori Itoh",
year = "2010",
month = "7",
day = "1",
doi = "10.1211/jpp.62.07.0011",
language = "English",
volume = "62",
pages = "901--907",
journal = "Journal of Pharmacy and Pharmacology",
issn = "0022-3573",
publisher = "Pharmaceutical Press",
number = "7",

}

TY - JOUR

T1 - Usefulness of serum cystatin C to determine the dose of vancomycin in critically ill patients

AU - Suzuki, Akio

AU - Imanishi, Yoshinori

AU - Nakano, Shiho

AU - Niwa, Takashi

AU - Ohmori, Tomofumi

AU - Shirai, Kunihiro

AU - Yoshida, Shozo

AU - Furuta, Nobuyuki

AU - Takemura, Masao

AU - Ito, Hiroyasu

AU - Ieiri, Ichiro

AU - Seishima, Mitsuru

AU - Ogura, Shinji

AU - Itoh, Yoshinori

PY - 2010/7/1

Y1 - 2010/7/1

N2 - Objectives Serum creatinine (Scr) is not a reliable marker of renal function in critically ill patients because of an enhancement of protein catabolism, which makes it difficult to adjust the dosage of renally eliminated drugs such as antibiotics. This study aimed to investigate whether serum cystatin C (Scys-C) could be used as a reliable marker of renal function. Methods We investigated whether Scys-C was a reliable marker of renal function in 56 critically ill patients. Subsequently, the usefulness of Scys-C to determine the initial loading and the maintenance dose of vancomycin was examined in 18 patients. Crea- tinine clearance (Ccr) was assessed from Scr and creatinine in urine collected over 24 h (24-h Ccr). Key findings There was a good correlation between 24-h Ccr and 1/Scys-C (r2 = 0.616), whereas less marked correlation was observed between 24-h Ccr and 1/Scr (r2 = 0.221). On the other hand, vancomycin concentration was predicted from population pharmacokinetic parameters based on a two-compartment linear model. There were significant correlations between real trough concentrations of vancomycin and the values predicted from Scys-C using various equations (r 2 = 0.416-0.488), while less pronounced relationships were observed between real concentrations and the values predicted from Scr (r2 = 0.134-0.187). Conclusions These findings suggest that Scys-C is a reliable marker reflecting renal function in critically ill patients and is applicable to determine the initial loading dose as well as the maintenance dose of vancomycin.

AB - Objectives Serum creatinine (Scr) is not a reliable marker of renal function in critically ill patients because of an enhancement of protein catabolism, which makes it difficult to adjust the dosage of renally eliminated drugs such as antibiotics. This study aimed to investigate whether serum cystatin C (Scys-C) could be used as a reliable marker of renal function. Methods We investigated whether Scys-C was a reliable marker of renal function in 56 critically ill patients. Subsequently, the usefulness of Scys-C to determine the initial loading and the maintenance dose of vancomycin was examined in 18 patients. Crea- tinine clearance (Ccr) was assessed from Scr and creatinine in urine collected over 24 h (24-h Ccr). Key findings There was a good correlation between 24-h Ccr and 1/Scys-C (r2 = 0.616), whereas less marked correlation was observed between 24-h Ccr and 1/Scr (r2 = 0.221). On the other hand, vancomycin concentration was predicted from population pharmacokinetic parameters based on a two-compartment linear model. There were significant correlations between real trough concentrations of vancomycin and the values predicted from Scys-C using various equations (r 2 = 0.416-0.488), while less pronounced relationships were observed between real concentrations and the values predicted from Scr (r2 = 0.134-0.187). Conclusions These findings suggest that Scys-C is a reliable marker reflecting renal function in critically ill patients and is applicable to determine the initial loading dose as well as the maintenance dose of vancomycin.

UR - http://www.scopus.com/inward/record.url?scp=77953980861&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77953980861&partnerID=8YFLogxK

U2 - 10.1211/jpp.62.07.0011

DO - 10.1211/jpp.62.07.0011

M3 - Article

C2 - 20636878

AN - SCOPUS:77953980861

VL - 62

SP - 901

EP - 907

JO - Journal of Pharmacy and Pharmacology

JF - Journal of Pharmacy and Pharmacology

SN - 0022-3573

IS - 7

ER -