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Colistin and Renal Failure: Single Center Experience

Year 2021, , 576 - 582, 22.09.2021
https://doi.org/10.31832/smj.876264

Abstract

Objective: Colistin is frequently used in intensive care units due to gram-negative microorganisms that are multi-drug resistant causing hospital-acquired infections. Colistin-related nephrotoxicity is a common side effect. In this study, we aimed to examine the general characteristics, treatments and outcomes of patients who developed renal replacement therapy (RRT) need due to colistin nephrotoxicity in the intensive care unit.
Materials and Methods: Age, gender, diagnosis of ICU admission, additional diseases, culture locations and microorganisms grown in culture, Acute Physiology, Assessment and Chronic Health Evaluation (APACHE II) score and Carlson Comorbidity Index (CCI) scores were recorded during admission to intensive care unit. Then, the laboratory parameters of the blood samples taken on the day the patients started colistin therapy and the day the treatment was terminated were recorded. In addition, the day of initiation of colistin therapy, total dose of colistin given, hemodialysis need of the patients, total intensive care hospitalization day and mortality rates were recorded. Differences in clinical and laboratory data between groups were evaluated statistically. p <0.05 is considered significant.
Results: It was observed that the need for renal replacement therapy developed in 33% of patients using colistin in the intensive care unit. Pre-treatment creatinine values were determined as independent risk factors for RRT. Apart from this, the age of the patients, APACHE II scores, urea and eGFR values before colistin therapy, colistin treatment dose and total colistin administration day, renal replacement therapy need were determined.
Conclusion: The need for RRT related to colistin therapy is common. Pre-treatment creatine levels were found to be an independent risk factor for the development of RRT.

References

  • 1-Platt R, Goldman RA, Hopkıns CC. Epidemiology of nosocomial infections. In: Gorbach SL, Bartlett JG, Blacklow NR, eds. İnfectious Diseases. Philadelphia: WB Sounders Company, 96-106, 1992
  • 2- Larsen AR. Nosocomial infections. In: Hoeprich PD, Jordan MC, eds. Infectious Disease 4th. ed Phledelpiha: J.B.Lippincott Company, 35-40, 1989
  • 3. Usluer G. 21.Yüzyılda hastane enfeksiyonları: neredeyiz? Türkiye Klinikleri Enfeksiyon Hastalıkları Özel Sayısı 2010;3(1):1-4.
  • 4-4.Li J, Nation RL, Milne RW, Turnidge JD, Coulthard K. Evaluation of colistin as an agent against multi-resistant gram-negative bacteria. Int J Antimicrob Agents 2005;25:11-25
  • 5 -Falagas ME, Kasiakou SK. Colistin: The revival of polymyxins for the management of multidrug-resistant gram-negative bacterial infections. Clin Infect Dis 2005; 40:1333-41.
  • 6.Falagas ME, Kasiakou SK. Colistin: the revival of polymyxins for the management of multidrug-resistant gram-negative bacterial infections. Clin Infect Dis 2005;40:1333–41
  • 7-Akajagbor DS, Wilson SL, Shere-Wolfe KD, Dakum P, Charurat ME, Gilliam BL. Higher incidence of acute kidney injury with intravenous colistimethate sodium compared with polymyxin B in critically ill patients at a tertiary care medical center. Clin Infect Dis 2013;57:1300–3. 11.
  • 8- Tuon FF, Rigatto MH, Lopes CK, Kamei LK, Rocha JL, Zavascki AP. Risk factors for acute kidney injury in patients treated with polymyxin B or colistin methanesulfonate sodium. Int J Antimicrob Agents 2014;43:349–52.
  • 9-Pogue JM, Lee J, Marchaim D, et al. Incidence of and risk factors for colistin-associated nephrotoxicity in a large academic health system. Clin Infect Dis 2011;53:879–84. 13
  • 10- Garonzik SM, Li J, Thamlikitkul V, et al. Population pharmacokinetics of colistin methanesulfonate and formed colistin in critically ill patients from a multicenter study provide dosing suggestions for various categories of patients. Antimicrob Agents Chemother 2011;55:3284–94.
  • 11- Kubin CJ, Ellman TM, Phadke V, Haynes LJ, Calfee DP, Yin MT. Incidence and predictors of acute kidney injury associated with intravenous polymyxin B therapy. J Infect 2012;65: 80–7.
  • 12-Kwon J-A, Lee JE, Huh W, et al. Predictors of acute kidney injury associated with intravenous colistin treatment. Int J Antimicrob Agents 2010;35:473–7.
  • 13- Deryke CA, Crawford AJ, Uddin N, Wallace MR. Colistin dosing and nephrotoxicity in a large community teaching hospital. Antimicrob Agents Chemother 2010;54:4503–5. 17. Collins JM, Haynes K, Gallagher JC. Emergent renal dysfunction with colistin pharmacotherapy. Pharmacotherapy 2013;33:812–6.
  • 14-Falagas ME, Kasiakou SK. Colistin: the revival of polymyxins fort he management of multidrug-resistant gram-negative bacterial infections. Clin Infect Dis 2005;40:1333-41. [Özet] [Tam Metin] [PDF]
  • 15-Giamarellou H. Multidrug-resistant gram-negative bacteria: how to treat and for how long. Int J Antimicrob Agents 2010;36:50-4. [Özet]
  • 16-Li J, Turnidge, J, Milne R, Nation RL, Coulthard K. In vitro pharmacodynamic properties of colistin and colistin methanesulfonate against Pseudomonas aeruginosa isolates from patients with cystic fibrosis. Antimicrob Agents Chemother 2001;45:781-5. [Özet] [Tam Metin] [PDF]
  • 17-Vaara M. Polymyxins and their novel derivatives. Curr Opin Microbiol. 2010;13:574-581.
  • 18-Rocco M, Montini L, Alessandri E, Venditti M, Laderchi A, De Pascale G, RaponiG, Vitale M, Pietropaoli P, Antonelli M. Risk factors for acute kidney injury in critically ill patients receiving high intravenous doses of colistin methanesulfonate and/or other nephrotoxic antibiotics: a retrospective cohort study. Crit Care. 2013 Aug 14;17(4)
  • 19- İ Ayse, T Melike,BG Ilhan ,D Abdurrrahim ,S Ziya. Determination of colistin-related nephrotoxicity and risk factors in intensive care unit. North Clin Istanb 2018;5(2):120–124 doi: 10.14744/nci.2017.42243
  • 20-Pogue JM, Lee J, Marchaim D, Yee V, Zhao JJ, et al. Incidence of and risk factors for colistin-associated nephrotoxicity in a large academic
  • 21-Koksal I, Kaya S, Gencalioglu E, Yilmaz G. Evaluation of Risk Factors for Intravenous Colistin Use-related Nephrotoxicity. Oman Med J 2016;31:318–21 [CrossRef ]
  • 22- AB Burcu, Y Fatma,Z Avşar, G Kamil Gönderen,T Melda ,A Gülbin. Colistin nephrotoxicity in the ICU: Is it different in the geriatric patients?Aging Clin Exp Res (2018) 30:573–580 DOI 10.1007/s40520-017-0827-3
  • 23. Arslan Zİ, Özbudak E, Türkyılmaz N, Cesur S, Alparslan V, Mirhanoğulları AF, et al. Evaluation of the Use of Colistin on Nephrotoxicity and Mortality in the Intensive Care Unit, Turkiye Klinikleri J Anest Reanim 2015;13:21–4. [CrossRef ]
  • 24. Kaya M, Tunçel YI, Kuru RN, Menteş S, Ünver S, Çeken S, et al. Retrospective Evaluation of Colistin Associated Nephrotoxicity at Oncology Hospital Intensive Care Unit, J Turk Soc Intens Care 2014;12: 51–6
  • 25. Inci A, Karabay A, Erus S, Demiraran Y. Nosocomial Infections and Associated Risk Factors in Geriatric Patients in the Intensive Care Unit. Eurasian J Emerg Med 2016; 15: 177–80. [CrossRef ]

Kolistin ve Böbrek Yetmezliği İlişkisi: Tek Merkez Deneyimi

Year 2021, , 576 - 582, 22.09.2021
https://doi.org/10.31832/smj.876264

Abstract

ÖZET
Amaç: Hastane kaynaklı infeksiyonlar ve bu infeksiyonlara neden olan çoklu ilaç direnci (ÇİD) olan gram negatif mikroorganizmalar nedeniyle yoğun bakımlarda kolistin sık kullanılmaktadır. Kolistine bağlı nefrotoksisite sık görülen bir yan etkidir. Bu çalışmada yoğun bakımda kullanılan kolistin nefrotoksisitesine bağlı renal replasman tedavisi (RRT) ihtiyacı gelişen hastaların genel özelliklerini , tedavilerini ve sonuçlarını incelemeyi amaçladık.
Gereç ve yöntemler: Her hastanın yaş, cinsiyet, yoğun bakıma yatış tanısı, ek hastalıkları, alınan kültür yerleri ve kültürde üreyen mikroorganizmalar, yoğun bakıma kabul esnasındaki Acute Physiology, Assessment and Chronic Health Evaluation (APACHE II) skoru ve Carlson Comorbidity İndeks skorları kaydedildi. Daha sonra hastaların kolistin tedavisine başlandığı gün ve tedavinin sonlandırıldığı gün alınan kan örneklerindeki laboratuar parametreleri kaydedildi. Ayrıca hastalara yatıştan itibaren kolistin tedavisine başlanma günü, total verilen kolistin dozu, hastaların hemodiyaliz ihtiyacı, toplam yoğun bakım yatış günü ve mortalite oranları kaydedildi. Gruplar arasındaki klinik ve laboratuvar verilere ilişkin farklılıklar istatistiksel olarak değerlendirildi. p<0.05 anlamlı kabul edildi.
Bulgular: Yoğun bakımda kolistin kullanan hastalarda % 33 oranında renal replasman tedavisi ihtiyacı geliştiği görüldü. RRT için tedavi öncesi kreatinin değerleri bağımsız risk faktörleri olarak saptanmıştır. Bunun dışında hastaların yaşı, APACHE II değerleri, CCI skorları, kolistin tedavisi öncesi üre ve eGFR değerleri, kolistin tedavi dozu ve total kolistin verilme günü renal replasman tedavisi ihtiyacı için b Sonuç : Kolistin tedavisine bağlı RRT ihtyacı sık görülmektedir. Tedavi öncesi kreatin değerleri RRT gelişmesi açısından bağımsız risk faktörü olarak bulunmuştur.

References

  • 1-Platt R, Goldman RA, Hopkıns CC. Epidemiology of nosocomial infections. In: Gorbach SL, Bartlett JG, Blacklow NR, eds. İnfectious Diseases. Philadelphia: WB Sounders Company, 96-106, 1992
  • 2- Larsen AR. Nosocomial infections. In: Hoeprich PD, Jordan MC, eds. Infectious Disease 4th. ed Phledelpiha: J.B.Lippincott Company, 35-40, 1989
  • 3. Usluer G. 21.Yüzyılda hastane enfeksiyonları: neredeyiz? Türkiye Klinikleri Enfeksiyon Hastalıkları Özel Sayısı 2010;3(1):1-4.
  • 4-4.Li J, Nation RL, Milne RW, Turnidge JD, Coulthard K. Evaluation of colistin as an agent against multi-resistant gram-negative bacteria. Int J Antimicrob Agents 2005;25:11-25
  • 5 -Falagas ME, Kasiakou SK. Colistin: The revival of polymyxins for the management of multidrug-resistant gram-negative bacterial infections. Clin Infect Dis 2005; 40:1333-41.
  • 6.Falagas ME, Kasiakou SK. Colistin: the revival of polymyxins for the management of multidrug-resistant gram-negative bacterial infections. Clin Infect Dis 2005;40:1333–41
  • 7-Akajagbor DS, Wilson SL, Shere-Wolfe KD, Dakum P, Charurat ME, Gilliam BL. Higher incidence of acute kidney injury with intravenous colistimethate sodium compared with polymyxin B in critically ill patients at a tertiary care medical center. Clin Infect Dis 2013;57:1300–3. 11.
  • 8- Tuon FF, Rigatto MH, Lopes CK, Kamei LK, Rocha JL, Zavascki AP. Risk factors for acute kidney injury in patients treated with polymyxin B or colistin methanesulfonate sodium. Int J Antimicrob Agents 2014;43:349–52.
  • 9-Pogue JM, Lee J, Marchaim D, et al. Incidence of and risk factors for colistin-associated nephrotoxicity in a large academic health system. Clin Infect Dis 2011;53:879–84. 13
  • 10- Garonzik SM, Li J, Thamlikitkul V, et al. Population pharmacokinetics of colistin methanesulfonate and formed colistin in critically ill patients from a multicenter study provide dosing suggestions for various categories of patients. Antimicrob Agents Chemother 2011;55:3284–94.
  • 11- Kubin CJ, Ellman TM, Phadke V, Haynes LJ, Calfee DP, Yin MT. Incidence and predictors of acute kidney injury associated with intravenous polymyxin B therapy. J Infect 2012;65: 80–7.
  • 12-Kwon J-A, Lee JE, Huh W, et al. Predictors of acute kidney injury associated with intravenous colistin treatment. Int J Antimicrob Agents 2010;35:473–7.
  • 13- Deryke CA, Crawford AJ, Uddin N, Wallace MR. Colistin dosing and nephrotoxicity in a large community teaching hospital. Antimicrob Agents Chemother 2010;54:4503–5. 17. Collins JM, Haynes K, Gallagher JC. Emergent renal dysfunction with colistin pharmacotherapy. Pharmacotherapy 2013;33:812–6.
  • 14-Falagas ME, Kasiakou SK. Colistin: the revival of polymyxins fort he management of multidrug-resistant gram-negative bacterial infections. Clin Infect Dis 2005;40:1333-41. [Özet] [Tam Metin] [PDF]
  • 15-Giamarellou H. Multidrug-resistant gram-negative bacteria: how to treat and for how long. Int J Antimicrob Agents 2010;36:50-4. [Özet]
  • 16-Li J, Turnidge, J, Milne R, Nation RL, Coulthard K. In vitro pharmacodynamic properties of colistin and colistin methanesulfonate against Pseudomonas aeruginosa isolates from patients with cystic fibrosis. Antimicrob Agents Chemother 2001;45:781-5. [Özet] [Tam Metin] [PDF]
  • 17-Vaara M. Polymyxins and their novel derivatives. Curr Opin Microbiol. 2010;13:574-581.
  • 18-Rocco M, Montini L, Alessandri E, Venditti M, Laderchi A, De Pascale G, RaponiG, Vitale M, Pietropaoli P, Antonelli M. Risk factors for acute kidney injury in critically ill patients receiving high intravenous doses of colistin methanesulfonate and/or other nephrotoxic antibiotics: a retrospective cohort study. Crit Care. 2013 Aug 14;17(4)
  • 19- İ Ayse, T Melike,BG Ilhan ,D Abdurrrahim ,S Ziya. Determination of colistin-related nephrotoxicity and risk factors in intensive care unit. North Clin Istanb 2018;5(2):120–124 doi: 10.14744/nci.2017.42243
  • 20-Pogue JM, Lee J, Marchaim D, Yee V, Zhao JJ, et al. Incidence of and risk factors for colistin-associated nephrotoxicity in a large academic
  • 21-Koksal I, Kaya S, Gencalioglu E, Yilmaz G. Evaluation of Risk Factors for Intravenous Colistin Use-related Nephrotoxicity. Oman Med J 2016;31:318–21 [CrossRef ]
  • 22- AB Burcu, Y Fatma,Z Avşar, G Kamil Gönderen,T Melda ,A Gülbin. Colistin nephrotoxicity in the ICU: Is it different in the geriatric patients?Aging Clin Exp Res (2018) 30:573–580 DOI 10.1007/s40520-017-0827-3
  • 23. Arslan Zİ, Özbudak E, Türkyılmaz N, Cesur S, Alparslan V, Mirhanoğulları AF, et al. Evaluation of the Use of Colistin on Nephrotoxicity and Mortality in the Intensive Care Unit, Turkiye Klinikleri J Anest Reanim 2015;13:21–4. [CrossRef ]
  • 24. Kaya M, Tunçel YI, Kuru RN, Menteş S, Ünver S, Çeken S, et al. Retrospective Evaluation of Colistin Associated Nephrotoxicity at Oncology Hospital Intensive Care Unit, J Turk Soc Intens Care 2014;12: 51–6
  • 25. Inci A, Karabay A, Erus S, Demiraran Y. Nosocomial Infections and Associated Risk Factors in Geriatric Patients in the Intensive Care Unit. Eurasian J Emerg Med 2016; 15: 177–80. [CrossRef ]
There are 25 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Articles
Authors

Havva Kocayigit 0000-0002-8719-7031

Kezban Özmen Süner 0000-0002-9822-4031

Özge Pekşen 0000-0001-8815-7894

Halil Kızılışık 0000-0001-9860-0271

Ali Fuat Erdem 0000-0001-6994-397X

Publication Date September 22, 2021
Submission Date February 7, 2021
Published in Issue Year 2021

Cite

AMA Kocayigit H, Özmen Süner K, Pekşen Ö, Kızılışık H, Erdem AF. Kolistin ve Böbrek Yetmezliği İlişkisi: Tek Merkez Deneyimi. Sakarya Tıp Dergisi. September 2021;11(3):576-582. doi:10.31832/smj.876264

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