We also examined the adverse effects of VCM treatment among the elderly patients and found that 12 of 94 (13%) developed nephrotoxicity after VCM administration. We detected a significant difference in increasing the percentage of nephrotoxicity in the severe hypoalbuminemia group (6 of 23 patients [26%]) compared with the non-severe hypoalbuminemia group (6 of 71 patients [8%]; P , 0.001) (Table 3).
In patients with AUC/MIC values of .450 μg × h/mL, the percentage of nephrotoxicity after VCM administration was significantly higher in the severe hypoalbuminemia group than in the non-severe hypoalbuminemia group (67% vs 33%; P , 0.001) (Figure 2), whereas the percentage of nephrotoxicity in the non-severe hypoalbuminemia group was significantly higher than in the severe hypoalbuminemia group for AUC/MIC values of ,250 μg × h/mL.
Discussion
This is the first study to have shown that severe hypoalbuminemia influences the half-life of VCM and treatment outcome.