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The following is a summary of “Factors associated with serum concentrations of vancomycin crystalline degradation product (CDP-1) among patients with chronic kidney disease,” published in the April 2025 issue of BMC Nephrology by Xu et al. 

Researchers conducted a retrospective study to identify clinical factors associated with serum trough concentrations of vancomycin crystalline degradation product (CDP-1) in patients with chronic kidney disease (CKD). 

They included patients with CKD receiving intravenous vancomycin and available steady-state serum trough levels. Patients were divided into three groups based on estimated creatinine clearance (eCrCl): G1 (60 < eCrCl ≤ 90 mL/min), G2 (30 < eCrCl ≤ 60 mL/min), and G3 (eCrCl ≤ 30 mL/min). CDP-1 serum concentrations were measured using ultra-high performance liquid chromatography‒tandem mass spectrometry (UPLC‒MS/MS). Vancomycin serum concentrations measured via chemiluminescence microparticle immunoassay (CMIA) were compared with those via UPLC‒MS/MS. Multiple linear regression analyses identified factors associated with CDP-1 concentration and the V_CMIA/V_UPLC-MS/MS ratio. 

The results showed that among 167 patients, 49 (29.34%) were in G1, 69 (41.32%) in G2, and 49 (29.34%) in G3. Significant differences in CDP-1 trough concentrations and V_CMIA/V_UPLC-MS/MS ratios were found between the groups. Multivariate analysis showed that eCrCl levels (P < 0.001), time from the initial dose to the trough level (P < 0.001), and vancomycin dose (P < 0.001) were associated with CDP-1 trough concentrations. The CDP-1 trough concentration was positively associated with the V_CMIA/V_UPLC-MS/MS ratio (P = 0.002). 

Investigators found that delayed trough level sampling could increase CDP-1 levels and overestimate vancomycin levels, particularly in patients with severe renal dysfunction. They suggested increasing TDM frequency and using quantitative methods to measure vancomycin without interference from CDP-1. 

Source: bmcnephrol.biomedcentral.com/articles/10.1186/s12882-025-04101-7