Division of Medicine, Mater Misericordiae University Hospital, Dublin, Ireland.
Service of Nephrology, Department of Medicine, Centre Hospitalier Universitaire de Montréal, Montréal, Québec, Canada.
Am J Nephrol. 2021;52(2):85-97. doi: 10.1159/000513742. Epub 2021 Mar 18.
Recent studies have identified the combination of vancomycin with piperacillin-tazobactam (VPT) to be associated with increased nephrotoxicity. Multiple, large cohort studies have found this widely used combination to have a higher risk of nephrotoxicity than other regimens in a variety of populations.
This review summarizes the epidemiology and clinical features of VPT-associated acute kidney injury (AKI). Potential mechanisms involved in the pathogenesis of this phenomenon are also discussed. Key Message: VPT-associated nephrotoxicity is a recently recognized clinical entity. Clinical strategies to minimize the risk of toxicity in this setting include antimicrobial stewardship, monitoring of kidney function, and emerging data supporting the potential role for novel biomarkers in predicting and managing AKI.
最近的研究表明，万古霉素与哌拉西林-他唑巴坦（VPT）联合使用与肾毒性增加有关。多项大型队列研究发现，这种广泛使用的联合用药在多种人群中的肾毒性风险高于其他方案。
本文综述了 VPT 相关急性肾损伤（AKI）的流行病学和临床特征。还讨论了该现象发病机制中涉及的潜在机制。
VPT 相关肾毒性是最近才被认识到的临床实体。在这种情况下，最大限度降低毒性风险的临床策略包括抗菌药物管理、肾功能监测以及支持新型生物标志物在预测和管理 AKI 方面潜在作用的新数据。
