Renal function affects the plasma concentration and hematological toxicity of linezolid in elderly patients: a propensity-matched cohort analysis

Renal function affects the plasma concentration and hematological toxicity of linezolid in elderly patients: a propensity-matched cohort analysis

Abstract Background The relationships of renal function with linezolid trough concentration (Cmin) and hematological toxicity have not been clarified in elderly patients. Methods In this propensity-matched cohort analysis, elderly patients receiving linezolid at four tertiary hospitals in Beijing be...

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Main Authors: Bing Liu, Guangrui Geng, Tingting Liu, Lingli Zhou, Fang Wang, Ping Yang, Jiaxin Liu, Junshuai Zhao, Cheng Zhao, Yue Wang, Minna Yang, Jing Fu, Jingyue Chen, Xiaomin Chen, Xiangqun Fang, Lixin Xie, Hongxia Li
Format: Article
Language:English
Published: BMC 2025-08-01
Series:BMC Geriatrics
Subjects:
Linezolid
Elderly patients
Renal function
Trough concentration
Hematological toxicity
Online Access:https://doi.org/10.1186/s12877-025-06241-9
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Summary:Abstract Background The relationships of renal function with linezolid trough concentration (Cmin) and hematological toxicity have not been clarified in elderly patients. Methods In this propensity-matched cohort analysis, elderly patients receiving linezolid at four tertiary hospitals in Beijing between May 2021 and March 2024 were included. The patients were grouped by renal function and propensity score matching (PSM) was used to balance baseline characteristics. Linezolid Cmin and hematological indices were monitored dynamically. Results Among 320 patients, 152 were eventually enrolled after PSM, including 56 (36.8%) patients with normal renal function (RN) and 96 (63.2%) patients with renal dysfunction (RD). Cmin at 3–5 (12.5 mg/L vs. 21.2 mg/L, P = 0.001) and 6–10 days (14.8 mg/L vs. 27.4 mg/L, P < 0001) was significantly lower in the RN group. The risk of linezolid-associated thrombocytopenia (LAT) and linezolid-associated anemia (LAA) in the RD group was 4.485 folds and 2.308 folds higher than in the RN group. The decreases in hematological indices were significantly higher in RD group than in RN group. Conclusions Renal function significantly affected linezolid Cmin and hematological toxicity, and the dose of linezolid should be reduced in elderly patients with renal dysfunction. Trial registration ChiCTR2100045707; Registration Date: 23/04/2021.
ISSN:1471-2318

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