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Serum Cystatin C Is a Major Predictor of Vancomycin Clearance in a Population Pharmacokinetic Analysis of Patients with Normal Serum Creatinine Concentrations

Authors
 Jae-Yong Chung  ;  Sung-Joon Jin  ;  Ji-Hyun Yoon  ;  Young-Goo Song 
Citation
 JOURNAL OF KOREAN MEDICAL SCIENCE, Vol.28(1) : 48-54, 2013 
Journal Title
 JOURNAL OF KOREAN MEDICAL SCIENCE 
ISSN
 1011-8934 
Issue Date
2013
MeSH
Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Anti-Bacterial Agents/blood ; Anti-Bacterial Agents/pharmacokinetics* ; Biomarkers/blood ; Body Weight ; Creatinine/blood* ; Cystatin C/blood* ; Demography ; Female ; Humans ; Male ; Middle Aged ; Models, Statistical ; Sex Factors ; Software* ; Vancomycin/blood ; Vancomycin/pharmacokinetics* ; Young Adult
Keywords
Cystatin C ; NONMEM ; Pharmacokinetics ; TDM ; Vancomycin
Abstract
We developed a population pharmacokinetic model of vancomycin by integrating the effects of cystatin C and other demographic factors in a large population of Korean patients with normal serum creatinine concentrations to elucidate the precise role of serum cystatin C concentrations in the prediction of vancomycin clearance. A population pharmacokinetic model of vancomycin was developed using NONMEM software from a total of 1,373 vancomycin concentration measurements in 678 patients whose serum creatinine concentrations were lower than 1.2 mg/dL. Covariate selection revealed that cystatin C was the most influential factor and had negative influence ((-0.78)) in the relationship. Total body weight, sex, age, and serum creatinine were also significantly correlated with the clearance. The estimated intersubject variabilities of clearance and volume of distribution were 24.7% and 25.1%, respectively. A 14-fold difference in predicted trough concentrations was observed according to only cystatin C concentrations in a population of simulated individuals with median demographic characteristics. The use of serum cystatin C as marker of vancomycin clearance for more accurate predictions of serum vancomycin concentrations could be useful, particularly among patients with normal serum creatinine concentrations.
Files in This Item:
T201300261.pdf Download
DOI
10.3346/jkms.2013.28.1.48
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Song, Young Goo(송영구) ORCID logo https://orcid.org/0000-0002-0733-4156
Yoon, Ji Hyun(윤지현)
Jin, Sung Joon(진성준)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/86292
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