Nephrotoxicity rates related to colistin and evaluation of risk factors

Year 2020, , 62 - 66, 04.01.2020

Ali Asan , Derya Karasu , Cuma Bülent Gül Gülsün Akıncıoğlu Nizameddin Koca , Mustafa Özgür Akça Canan Yılmaz , İsra Karaduman Şükran Köse

https://doi.org/10.18621/eurj.459250

Cited By: 2

Abstract

Objectives: Colistimethate
sodium (colistin) is the member of polymyxins, the cyclic structured cationic
polypeptide antibiotics. The purpose of our study is to determine the patients’
nephrotoxicity rates and risk factors related to nephrotoxicity development
that are under colistin treatment in the tertiary intensive care unit (ICU).

Methods: One-hundred
colistin received patients files were reviewed retrospectively, who were in
tertiary ICU in Bursa Yüksek Ihtisas Training and Research Hospital. Fifteen
patients with the history of renal failurewere excluded from the study. The
data before the first colistin treatment was taken into consideration for the
patients received repetitive colistin treatment. RIFLE (Risk, Injury, Failure,
Loss of kidney function, and End-stage kidney disease) classification was used
for the evaluation of nephrotoxicity.

Results: The
patients mean age was 67.81 ± 16.56 years (range: 21-94) and 52.9% were male. Nephrotoxicity was determined in 35 (41.2%) patients.
According to the RIFLE classification the nephrotoxicity rates were determined
for risk, injury and deficiency were 24.7%, 10.6% and 5.9%, respectively.
Nephrotoxicity was detectedin 9 (25.7%) out of 35 patients on the first day of
the colistin treatment. Mortality rate was observed as 82.9% in patients with
nephrotoxicity.

Conclusions: Colistin
treatment is preferable for the treatment of multi drug resistant infections in
intensive care unit. The patients,under certain circumstances, i.e., malignancy, using additional nephrotoxic agent and elder age must be closely monitored for the possible
nephrotoxicity development. 

Keywords

colistin, nephrotoxicity, RIFLE score

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