Incidence and predictors of acute kidney injury associated with intravenous polymyxin B therapy. Academic Article uri icon

Overview

abstract

  • BACKGROUND: Increases in multidrug-resistance among gram-negative organisms have necessitated the use of polymyxins. To date, the incidence of acute kidney injury (AKI) associated with polymyxin B has not been evaluated using RIFLE criteria. METHODS: Adult patients who received polymyxin B were retrospectively evaluated to determine the incidence of AKI during polymyxin B therapy using RIFLE criteria. Predictors of AKI were identified by comparing characteristics of patients with and without AKI. RESULTS: A total of 73 patients were included. The incidence of AKI was 60%. Ten (14%) patients discontinued therapy due to nephrotoxicity. Median duration of polymyxin B was 11 days with a median cumulative dose of 18 mg/kg. Concomitant nephrotoxins were received in 69 (95%). Patients with AKI had a higher median cumulative dose (1578 mg vs. 800 mg; p = 0.02), a higher body mass index (BMI) (27.2 vs. 24.5 kg/m(2); p = 0.03), and were more likely to receive vancomycin (82% vs. 55%; p = 0.03) compared to those without AKI. After controlling for polymyxin B duration, independent predictors of AKI were higher BMI and concomitant vancomycin. CONCLUSIONS: The incidence of AKI during polymyxin B therapy was 60%. Further studies are needed to define dosing parameters that maximize efficacy and minimize nephrotoxicity.

publication date

  • February 2, 2012

Research

keywords

  • Acute Kidney Injury
  • Anti-Bacterial Agents
  • Polymyxin B

Identity

Scopus Document Identifier

  • 84861481150

Digital Object Identifier (DOI)

  • 10.1016/j.jinf.2012.01.015

PubMed ID

  • 22326553

Additional Document Info

volume

  • 65

issue

  • 1