Bahadır Ceylan1,2, Müdür Taniş3, Muhammed Emin Akkoyunlu4, Ahmet Çınar5, Ayşe Ruhkar Kurt6, Yasemin Akkoyunlu6, Didem Ozkan4, Hatice Kutbay Ozcelik4, Turan Aslan6, Muzaffer Fincancı3, Şule Vatansever7, Kadir İdin8, Emine Guler8, Harun Uysal8. 1. Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Bezmialem Vakıf University, Vatan Caddesi, Fatih, Istanbul, Turkey. bceylan2004@yahoo.com. 2. Yıldırım Beyazıt Caddesi, Bosnapark Evleri, No: 8, Daire 13, Kat 3, Zafer Mahallesi, Yenibosna, Bahçelievler, Istanbul, Turkey. bceylan2004@yahoo.com. 3. Department of Infectious, Diseases and Clinical Microbiology, Istanbul Training and Research Hospital, Istanbul, Turkey. 4. Faculty of Medicine, Department of Thoracic Diseases, Bezmialem Vakıf University, Istanbul, Turkey. 5. Faculty of Medicine, Department of Internal Medicine, Bezmialem Vakıf University, Istanbul, Turkey. 6. Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Bezmialem Vakıf University, Vatan Caddesi, Fatih, Istanbul, Turkey. 7. Department of Anesthesiology and Reanimation, Istanbul Training and Research Hospital, Istanbul, Turkey. 8. Faculty of Medicine, Department of Anesthesiology and Reanimation, Bezmialem Vakıf University, Istanbul, Turkey.
Abstract
AIM: The aim of this study was to identify the predictors of acute renal injury associated with colistin treatment. METHODS: The patients who received treatment with colistin for more than 3 days were included in this retrospective cohort study. Acute renal injury was defined by the RIFLE (Risk Injury Failure Loss End stage renal disease) criteria. Patients whose serum creatinine levels increased at least 1.5-fold compared with baseline value were considered as cases with renal injury. The independent variables determining the development of acute renal injury were investigated by survival analysis. RESULTS: A total of 112 cases [67 (59.8 %) were male, median age 64 (range: 18-93) years] were included in the study. Acute renal injury occurred in 66 (58.9 %) patients. Renal injury developed in first 7 days of the colistin therapy in 52 (78.8 %) cases and at day 8-23 in 14 (21.2 %) cases. On the day with highest levels of creatinine, 25 (22.3 %), 17 (15.2 %), and 33 (29.5 %) cases were in 'Risk', 'Injury', and 'Failure' group, respectively, according to RIFLE criteria. We identified three independent risk factors predicting acute colistin-induced renal injury: advanced age, low serum albumin levels, and high serum total bilirubin levels [odds ratio (confidence interval) = 1.022 (1.006-1.037), 0.643 (0.415-0.994), and 1.129 (1.014-1.257), respectively]. CONCLUSIONS: The advanced age, low serum albumin levels, and high serum total bilirubin levels are independent risk factors for colistin-induced nephrotoxicity.
AIM: The aim of this study was to identify the predictors of acute renal injury associated with colistin treatment. METHODS: The patients who received treatment with colistin for more than 3 days were included in this retrospective cohort study. Acute renal injury was defined by the RIFLE (Risk Injury Failure Loss End stage renal disease) criteria. Patients whose serum creatinine levels increased at least 1.5-fold compared with baseline value were considered as cases with renal injury. The independent variables determining the development of acute renal injury were investigated by survival analysis. RESULTS: A total of 112 cases [67 (59.8 %) were male, median age 64 (range: 18-93) years] were included in the study. Acute renal injury occurred in 66 (58.9 %) patients. Renal injury developed in first 7 days of the colistin therapy in 52 (78.8 %) cases and at day 8-23 in 14 (21.2 %) cases. On the day with highest levels of creatinine, 25 (22.3 %), 17 (15.2 %), and 33 (29.5 %) cases were in 'Risk', 'Injury', and 'Failure' group, respectively, according to RIFLE criteria. We identified three independent risk factors predicting acute colistin-induced renal injury: advanced age, low serum albumin levels, and high serum total bilirubin levels [odds ratio (confidence interval) = 1.022 (1.006-1.037), 0.643 (0.415-0.994), and 1.129 (1.014-1.257), respectively]. CONCLUSIONS: The advanced age, low serum albumin levels, and high serum total bilirubin levels are independent risk factors for colistin-induced nephrotoxicity.
Authors: Timothy P Gauthier; William R Wolowich; Arathi Reddy; Ennie Cano; Lilian Abbo; Laura B Smith Journal: Antimicrob Agents Chemother Date: 2012-02-27 Impact factor: 5.191
Authors: M Bassetti; E Repetto; E Righi; S Boni; M Diverio; M P Molinari; M Mussap; S Artioli; F Ansaldi; P Durando; G Orengo; F Bobbio Pallavicini; C Viscoli Journal: J Antimicrob Chemother Date: 2008-01-03 Impact factor: 5.790