万古霉素引起急性肾衰竭

1例36岁男性白血病患者,因肺部感染给予万古霉素1g加入0.9%氯化钠注射液100mL,1次/12h静脉滴注;莫西沙星0.4g,1次/12h静脉滴注。给药3d后实验室检查示SCr549μmol/L,BUN11.17mmol/L,血K＋3.76mmol/L。停用万古霉素,改用利奈唑胺,继续使用莫西沙星。患者情况恶化,出现恶心、下肢水肿、腹胀,尿量1000mL/d,SCr848μmol/L,BUN19.8mmol/L。遂行血液滤过,3次后患者症状消失,肾功能各项指标均恢复正常。

Vancomycin-induced acute renal failure

A 36-year-old man with leukemia received an IV infusion of vancomycin 1 g in 0.9% sodium chloride 100 mL once every 12 hours and an IV infusion of moxfloxacin 0.4 g once every 12 hours for respiratory infections.Three days later,laboratory tests revealed the following levels：SCr 549 μmol/L,BUN 11.17 mmol/L,serum K＋ 3.76 mmol/L.Vancomycin was withdrawn and changed to linezolid.Moxfloxacin was continued.The patient＇s condition continued to worsen and he developed nausea,edema in lower limbs,and abdominal distension.His urine volume was 1000 mL/d.Meanwhile his SCr level was 848 μmol/L and BUN level was 19.8 mmol/L.Subsequently,he received hemofiltration.After three times of hemofiltration,his symptoms disappeared and renal function indices returned to within the normal range.