Usefulness of serum cystatin C to determine the dose of vancomycin in neonate
PurposeThe vancomycin dosage regimen is regularly modified according to the patient's glomerular filtration rate (GFR). In the present study, we aimed to assess the usefulness of serum cystatin C (Cys-C) concentration, compared with serum creatinine (SCr) concentration, for predicting vancomyci...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Korean Pediatric Society
2015-11-01
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| Series: | Korean Journal of Pediatrics |
| Subjects: | |
| Online Access: | http://kjp.or.kr/upload/pdf/kjped-58-421.pdf |
| _version_ | 1818152763858616320 |
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| author | Jeong Eun Shin Soon Min Lee Ho Seon Eun Min Soo Park Kook In Park Ran Namgung |
| author_facet | Jeong Eun Shin Soon Min Lee Ho Seon Eun Min Soo Park Kook In Park Ran Namgung |
| author_sort | Jeong Eun Shin |
| collection | DOAJ |
| description | PurposeThe vancomycin dosage regimen is regularly modified according to the patient's glomerular filtration rate (GFR). In the present study, we aimed to assess the usefulness of serum cystatin C (Cys-C) concentration, compared with serum creatinine (SCr) concentration, for predicting vancomycin clearance (CLvcm) in neonates.MethodsWe retrospectively analyzed the laboratory data of 50 term neonates who were admitted to the neonatal intensive care unit and received intravenous vancomycin, and assessed the pharmacokinetic profiles. Creatinine clearance (CLcr) and GFR based on Cys-C (GFRcys-c) were estimated using the Schwartz and Larsson formulas, respectively.ResultsThe mean CLvcm (±standard deviation) was 74.52±31.17 L/hr, the volume of distribution of vancomycin was 0.67±0.14 L, and vancomycin half-life was 9.16±17.42 hours. The SCr was 0.46±0.25 mg/dL and serum Cys-C was 1.43±0.34 mg/L. The peak and trough concentrations of vancomycin were 24.65±14.84 and 8.10±5.35 mcg/mL, respectively. The calculated GFR based on serum creatinine concentration (GFR-Cr) and GFRcys-c were 70.2±9.45 and 63.6±30.18 mL/min, respectively. The correlation constant for CLvcm and the reciprocal of Cys-C (0.479, P=0.001) was significantly higher than that for CLvcm and the reciprocal of SCr (0.286, P=0.044). GFRcys-c was strongly correlated with CLvcm (P=0.001), and the correlation constant was significantly higher than that for CLvcm and CLcr (0.496, P=0.001). Linear regression analysis showed that only GFRcys-c was independently and positively correlated with CLvcm (F=41.9, P<0.001).ConclusionThe use of serum Cys-C as a marker of CLvcm could be beneficial for more reliable predictions of serum vancomycin concentrations, particularly in neonates. |
| first_indexed | 2024-12-11T13:59:54Z |
| format | Article |
| id | doaj.art-91bbf4022a3a41f688f8c3a8777471b5 |
| institution | Directory Open Access Journal |
| issn | 1738-1061 2092-7258 |
| language | English |
| last_indexed | 2024-12-11T13:59:54Z |
| publishDate | 2015-11-01 |
| publisher | Korean Pediatric Society |
| record_format | Article |
| series | Korean Journal of Pediatrics |
| spelling | doaj.art-91bbf4022a3a41f688f8c3a8777471b52022-12-22T01:03:53ZengKorean Pediatric SocietyKorean Journal of Pediatrics1738-10612092-72582015-11-01581142142610.3345/kjp.2015.58.11.4212014600075Usefulness of serum cystatin C to determine the dose of vancomycin in neonateJeong Eun Shin0Soon Min Lee1Ho Seon Eun2Min Soo Park3Kook In Park4Ran Namgung5Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea.Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea.Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea.Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea.Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea.Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea.PurposeThe vancomycin dosage regimen is regularly modified according to the patient's glomerular filtration rate (GFR). In the present study, we aimed to assess the usefulness of serum cystatin C (Cys-C) concentration, compared with serum creatinine (SCr) concentration, for predicting vancomycin clearance (CLvcm) in neonates.MethodsWe retrospectively analyzed the laboratory data of 50 term neonates who were admitted to the neonatal intensive care unit and received intravenous vancomycin, and assessed the pharmacokinetic profiles. Creatinine clearance (CLcr) and GFR based on Cys-C (GFRcys-c) were estimated using the Schwartz and Larsson formulas, respectively.ResultsThe mean CLvcm (±standard deviation) was 74.52±31.17 L/hr, the volume of distribution of vancomycin was 0.67±0.14 L, and vancomycin half-life was 9.16±17.42 hours. The SCr was 0.46±0.25 mg/dL and serum Cys-C was 1.43±0.34 mg/L. The peak and trough concentrations of vancomycin were 24.65±14.84 and 8.10±5.35 mcg/mL, respectively. The calculated GFR based on serum creatinine concentration (GFR-Cr) and GFRcys-c were 70.2±9.45 and 63.6±30.18 mL/min, respectively. The correlation constant for CLvcm and the reciprocal of Cys-C (0.479, P=0.001) was significantly higher than that for CLvcm and the reciprocal of SCr (0.286, P=0.044). GFRcys-c was strongly correlated with CLvcm (P=0.001), and the correlation constant was significantly higher than that for CLvcm and CLcr (0.496, P=0.001). Linear regression analysis showed that only GFRcys-c was independently and positively correlated with CLvcm (F=41.9, P<0.001).ConclusionThe use of serum Cys-C as a marker of CLvcm could be beneficial for more reliable predictions of serum vancomycin concentrations, particularly in neonates.http://kjp.or.kr/upload/pdf/kjped-58-421.pdfVancomycinCystatin CClearance |
| spellingShingle | Jeong Eun Shin Soon Min Lee Ho Seon Eun Min Soo Park Kook In Park Ran Namgung Usefulness of serum cystatin C to determine the dose of vancomycin in neonate Korean Journal of Pediatrics Vancomycin Cystatin C Clearance |
| title | Usefulness of serum cystatin C to determine the dose of vancomycin in neonate |
| title_full | Usefulness of serum cystatin C to determine the dose of vancomycin in neonate |
| title_fullStr | Usefulness of serum cystatin C to determine the dose of vancomycin in neonate |
| title_full_unstemmed | Usefulness of serum cystatin C to determine the dose of vancomycin in neonate |
| title_short | Usefulness of serum cystatin C to determine the dose of vancomycin in neonate |
| title_sort | usefulness of serum cystatin c to determine the dose of vancomycin in neonate |
| topic | Vancomycin Cystatin C Clearance |
| url | http://kjp.or.kr/upload/pdf/kjped-58-421.pdf |
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