Glomerular Disease in Patients With Acute Kidney Injury After Vancomycin Treatment—Need for Kidney Biopsy

Vancomycin is the preferred treatment for methicillin-resistant Staphylococcus aureus (MRSA) infections but is known for its nephrotoxic effect. It is often administered empirically before culture results are available. In vancomycin-associated nephrotoxicity, kidney biopsy reveals acute tubular necrosis (ATN) and mild acute interstitial nephritis (AIN) as the primary morphologic findings1,2. Nevertheless, a substantial number of kidney biopsies from patients with vancomycin-associated acute kidney injury (AKI) also reveal infection-related glomerulonephritis (IRGN)3.