Nephrotoxicity rates related to colistin and evaluation of risk factors

Abstract

Objectives: Colistimethate sodium (colistin) is the member of polymyxins, the cyclic structured cationicpolypeptide antibiotics. The purpose of our study is to determine the patients’ nephrotoxicity rates and riskfactors related to nephrotoxicity development that are under colistin treatment in the tertiary intensive careunit (ICU).Methods: One-hundred colistin received patients files were reviewed retrospectively, who were in tertiaryICU in Bursa Yüksek Ihtisas Training and Research Hospital. Fifteen patients with the history of renalfailurewere excluded from the study. The data before the first colistin treatment was taken into considerationfor 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. Nephrotoxicitywas determined in 35 (41.2%) patients. According to the RIFLE classification the nephrotoxicity rates weredetermined for risk, injury and deficiency were 24.7%, 10.6% and 5.9%, respectively. Nephrotoxicity wasdetectedin 9 (25.7%) out of 35 patients on the first day of the colistin treatment. Mortality rate was observedas 82.9% in patients with nephrotoxicity.Conclusions: Colistin treatment is preferable for the treatment of multi drug resistant infections in intensivecare unit. The patients, under certain circumstances, i.e., malignancy, using additional nephrotoxic agent andelder age must be closely monitored for the possible nephrotoxicity development.