A Comparative Study of High-Dose Colistin Administration for the Management of Multidrug-Resistant Gram-Negative Infections in the ICU

Table 3

Risk factors for the development of nephrotoxicity during CMS therapy.

Risk factors	NO AKI (N = 23)	AKI (N = 12)	value	value-adjusted
Age (mean ± SD)	45.9 ± 16.71	58.5 ± 14.48	0.034	0.753
Male, n (%)	14 (60.9%)	9 (75%)	0.403
APACHE II score (mean ± SD)	20.4 ± 5.26	21.2 ± 4.59	0.687
ICU duration, median days (IQR)	28 (21)	36.5 (22)	0.190
CMS duration, median days (IQR)	14 (8)	14 (19)	0.604
Number of nephrotoxic agents^1				0.178
0	13 (56.5%)	2 (16.7%)
1	5 (21.7%)	5 (41.7%)
2	5 (21.7%)	2 (16.7%)	0.028
3	0 (0%)	2 (16.7%)
4	0 (0%)	1 (8.3%)
DM, n (%)	3 (13%)	4 (33.3%)	0.200
HTN, n (%)	5 (21.7%)	6 (50%)	0.087
COPD, n (%)	1 (4.3%)	3 (25%)	0.106
Hypoalbuminaemia^2, mean serum level ± SD	3.0 ± 0.45	2.8 ± 0.57	0.235
AST, mean serum level ± SD	68 ± 53.9	93.9 ± 83.7	0.536
ALT, mean serum level ± SD	73.3 ± 59.8	93.9 ± 83.7	0.418
Hyperbilirubinaemia^3, mean serum level ± SD	1.2 ± 0.88	3.0 ± 2.49	0.029	0.008

APACHE, Acute Physiology and Chronic Health Evaluation; CMS, colistimethate sodium; ICU, intensive care unit; SD, standard deviation; DM, diabetes mellitus; HTN, hypertension; COPD, chronic obstructive pulmonary disease; AST, alanine aminotransferase; ALT, aspartate aminotransferase, IQR; interquartile range. ¹Nephrotoxic agents include vancomycin, aminoglycosides, angiotensin-converting enzyme inhibitors, diuretics, radio contrast agents, and vasopressors. ²Defined as a serum albumin level <3 g/dL. ³Defined as a total bilirubin level >5 mg/dL.