Colistin and Renal Failure: Single Center Experience

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.

Keywords

• colistin
• renal failure
• intensive care

Kolistin ve Böbrek Yetmezliği İlişkisi: Tek Merkez Deneyimi

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.

Keywords

• kolistin
• yoğun bakım
• böbrek yetmezliği

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