Department of Pharmacy, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan; Molecular Regulation of Aging, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan; Department of Practical Pharmacy, Faculty of Pharmaceutical Sciences, Toho University, Chiba, Japan.
Department of Practical Pharmacy, Faculty of Pharmaceutical Sciences, Toho University, Chiba, Japan;, Email:
Pharmazie. 2022 Feb 1;77(2):76-80. doi: 10.1691/ph.2022.1972.
Accurate assessment of renal function is essential for determining serum vancomycin (VCM) concentration. Creatinine clearance (Ccr)-calculated using the Cockcroft and Gault (CG) equation-can be used to evaluate renal function for determining VCM dosage. However, Ccr-based evaluation may not be an accurate representation of the renal function in the elderly. Herein, we examine the effectiveness of estimated glomerular filtration rate (eGFR) calculated using the Berlin Initiative Study-1 (BIS1) equation, for predicting the serum VCM concentration. Herein, we retrospectively analyzed patients (aged ≥ 75 years) who had received VCM. Serum VCM concentration was predicted based on Ccr and eGFR. eGFR was calculated using the Japanese equation for eGFR (eGFR), Modification of Diet in Renal Disease (MDRD) equation (eGFR), chronic kidney disease epidemiology collaboration (CKD-EPI) equation (eGFR), and BIS1 equation (eGFR). The predicted serum VCM concentration was compared with the measured values. Prediction bias, accuracy, and precision were evaluated by calculating the mean prediction error (ME), mean absolute prediction error (MAE), and root mean squared prediction error (RMSE). Our results showed that the ME between the measured and the predicted values calculated using Ccr and each eGFR was the largest and smallest when calculated based on Ccr and eGFR respectively. MAE and RMSE were the largest and smallest when calculated based on Ccr and eGFR respectively. A significant difference was observed in the MAE associated with eGFR, eGFR, and eGFR compared to that associated with eGFR. In conclusion, our results suggest that the BIS1 equation might be useful for determining the VCM dosage in the elderly.
准确评估肾功能对于确定血清万古霉素（VCM）浓度至关重要。使用 Cockcroft 和 Gault（CG）方程计算的肌酐清除率（Ccr）可用于评估肾功能以确定 VCM 剂量。然而，基于 Ccr 的评估可能不能准确反映老年人的肾功能。在此，我们研究了使用柏林倡议研究-1（BIS1）方程估算的肾小球滤过率（eGFR）预测血清 VCM 浓度的有效性。在此，我们回顾性分析了接受 VCM 治疗的患者（年龄≥75 岁）。根据 Ccr 和 eGFR 预测血清 VCM 浓度。使用日本 eGFR 方程（eGFR）、肾脏病饮食改良公式（MDRD）方程（eGFR）、慢性肾脏病流行病学合作研究（CKD-EPI）方程（eGFR）和 BIS1 方程（eGFR）计算 eGFR。将预测的血清 VCM 浓度与测量值进行比较。通过计算平均预测误差（ME）、平均绝对预测误差（MAE）和均方根预测误差（RMSE）来评估预测偏差、准确性和精密度。结果表明，当分别基于 Ccr 和 eGFR 计算时，ME 是测量值与使用 Ccr 和每种 eGFR 计算的预测值之间的最大和最小。MAE 和 RMSE 是最大和最小的时分别基于 Ccr 和 eGFR 计算。与 eGFR 相比，eGFR、eGFR 和 eGFR 的 MAE 存在显著差异。总之，我们的结果表明，BIS1 方程可能有助于确定老年人的 VCM 剂量。
