Risk Factors for Colistin-Associated Acute Kidney Injury: A Multicenter Study from Turkey

• Published in: Japanese Journal of Infectious Diseases Vol. 69; no. 2; pp. 109 - 112
• Main Authors: Gul, Serdar, Kuscu, Ferit, Aydemir, Hande, Ozturk, Dogan Baris, Deveci, Ozcan, Duygu, Fazilet, Kacmaz, Birgul, Yaman, Ferda, Aslan, Emel
• Format: Journal Article
• Language: English
• Published: Japan National Institute of Infectious Diseases, Japanese Journal of Infectious Diseases Editorial Committee 2016
• Subjects: acute kidney injury; Acute Kidney Injury - chemically induced; Acute Kidney Injury - epidemiology; Adolescent; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents - administration & dosage; Anti-Bacterial Agents - adverse effects; colistin; Colistin - administration & dosage; Colistin - adverse effects; Colistin - analogs & derivatives; Drug Interactions; Female; Hospitals, University; Humans; Incidence; Male; Middle Aged; Retrospective Studies; Risk Factors; Sodium Potassium Chloride Symporter Inhibitors - administration & dosage; Turkey; Young Adult
• ISSN: 1344-6304; 1884-2836
• DOI: 10.7883/yoken.JJID.2014.501

The aim of this study was to investigate the incidence of acute kidney injury (AKI) and risk factors due to colistin use in patients infected with multidrug-resistant pathogens. This multicenter, retrospective, observational study was conducted in Turkey, at 5 different research and university hospitals. Cox regression analyses were performed, to determine independent predictors of AKI. From April 2012 to July 2014, a total of 216 patients aged between 18–94 years, treated with colistimethate sodium (CMS) were included in the study. The mean age of the patients was 60.3 ± 20.1 years. The overall incidence of AKI was 34.3% (74/216) at any time during treatment. Concomitant use of loop diuretics, baseline creatinine level, and CMS dosage were independently associated with AKI. According to our results, patients with higher baseline creatinine levels, or patients who had to use concomitant loop diuretics may need to be monitored more closely, and dose adjustment should be done promptly. More comprehensive studies are, however, still needed to evaluate the efficacy of low-dose colistin since higher doses tend to increase the risk of AKI.