Vancomycin dosing in critically ill patients receiving renal replacement therapy: a critical appraisal of the toxicity threshold and external validation - Takeaways - MDSpire
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Evaluating Vancomycin Dosage in Critically Ill Patients Undergoing Renal Replacement Therapy: Insights on Toxicity Thresholds and External Validation

  • By

  • Jiaojiao Zhou

  • Haibo Lei

  • Ronghui Li

  • Xiang Liu

  • Guanghui Chen

  • September 22, 2026

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  • 1

    The authors of the article present vancomycin dosing nomograms for critically ill patients undergoing renal replacement therapy.

  • 2

    Concerns are raised regarding the toxicity threshold used in dosing simulations, which may not align with established guidelines.

  • 3

    External validation reporting indicates systematic overprediction of vancomycin concentrations in a distinct dataset.

  • 4

    The nomogram does not include residual urine output as a stratification variable, which affects vancomycin clearance.

  • 5

    Recommendations include revising the toxicity threshold to 600 mg·h/L and incorporating urine output into the nomogram.

Original Source(s)

Vancomycin dosing in critically ill patients receiving renal replacement therapy: a critical appraisal of the toxicity threshold and external validation

  • by Jiaojiao Zhou, Haibo Lei, Ronghui Li, Xiang Liu, Guanghui Chen

  • September 22, 2026

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