Attributable nephrotoxicity of vancomycin in critically ill patients: a marginal structural model study.

Background: Although vancomycin nephrotoxicity is recognizable, critically ill patients have other potential reasons for acute kidney injury (AKI) and determining its attributable nephrotoxic risk in this population can be cumbersome.

Objectives: To determine the risk of AKI attributable to vancomycin, controlling for baseline and time-dependent confounders.

Methods: Time-fixed and daily time-varying variables were extracted from a large public database.

Kidney Disease Improving Global Outcomes or creatinine kinetics criteria in acute kidney injury: a proof of concept study.

Background: It has been recently mathematically demonstrated that the percentage increase in serum creatinine (SCr) can delay acute kidney injury (AKI) diagnosis in patients with previous chronic kidney disease (CKD). Based on creatinine (Cr) kinetics, it was suggested a new AKI classification using absolute increase in SCr elevation over specified time periods. However, this classification has not been evaluated in clinical studies.