Prospective cohort finds acute nephrotoxicity in 25.2% of vancomycin-treated inpatients

A prospective cohort study of 345 inpatients prescribed vancomycin at Debre Markos Comprehensive Specialized Hospital found acute nephrotoxicity in 25.2% of participants. Nephrotoxicity was defined as an increase in serum creatinine of at least 0.5 mg/dL from baseline. The abstract identifies several factors associated with the outcome, including educational status, urinary tract infection and concomitant omeprazole use, but the study does not establish that these factors caused kidney injury.

The researchers collected demographic, clinical and laboratory data from inpatients treated with vancomycin between April 1, 2024, and February 28, 2025. Data were analyzed using SPSS, with statistical significance set at P < 0.05. The study was prospective and observational, so its reported associations should not be interpreted as proof that vancomycin or any accompanying factor directly produced the observed changes in kidney function.

According to the abstract, patients who had never attended school had an adjusted odds ratio (AOR) of 9.86 for acute nephrotoxicity compared with the reference group (P = 0.012; 95% CI, 1.67–58.16). Those who could read and write had an AOR of 11.49 (P = 0.013; 95% CI, 1.69–78.07). Urinary tract infection was associated with an AOR of 15.5 (P = 0.02; 95% CI, 1.49–161.02), while concomitant omeprazole use was associated with an AOR of 6.43 (P = 0.002; 95% CI, 2.01–20.54).

The abstract also reported lower odds of acute nephrotoxicity among housewives (AOR 0.11; P = 0.004; 95% CI, 0.03–0.50), farmers (AOR 0.04; P < 0.001; 95% CI, 0.007–0.18) and people working in private jobs (AOR 0.061; P = 0.004; 95% CI, 0.01–0.35) than the relevant reference group. These estimates come from a single-center cohort and should be read as reported associations rather than causal effects. The available source is an abstract published in BMC Infectious Diseases, with the article noting that the version is subject to further edits; the abstract does not provide the full methodological details, adjustment variables, subgroup results or limitations needed for a complete assessment of the findings.

The authors concluded that the findings highlight the importance of clinical awareness surrounding potentially high-risk medication use. They further state that renal-function screening should be a central component of care for vulnerable patients receiving vancomycin. The summary does not report an intervention trial, so it provides no direct evidence that a screening strategy reduces nephrotoxicity or improves clinical outcomes.

Subject of Research: Predictors of acute nephrotoxicity among vancomycin-treated inpatients in a prospective cohort study

Article Title: Assessment of nephrotoxicity risk and its predictors among vancomycin-treated patients admitted at Debre Markos comprehensive specialized hospital

Article References: Biazen, M. G., Mengist, A., Abebaw, A., Tegegne, B. A., Muche, Y., Biyazin, Y., Endalew, B., Meharie, B. G., & Elmneh, H. T. (2026). Assessment of nephrotoxicity risk and its predictors among vancomycin-treated patients admitted at Debre Markos comprehensive specialized hospital. BMC Infectious Diseases. https://doi.org/10.1186/s12879-026-14491-0

Image Credits: AI Generated

DOI: 10.1186/s12879-026-14491-0

Keywords: vancomycin, acute nephrotoxicity, serum creatinine, acute kidney injury, prospective cohort, inpatients, risk factors, omeprazole, urinary tract infection, Assessment, nephrotoxicity, risk