Colistin-Induced Acute Kidney Injury and the Effect on Survival in Patients with Multidrug-Resistant Gram-Negative Infections: Significance of Drug Doses Adjusted to Ideal Body Weight
Table 1
Demographic data, baseline characteristics of patients with and without AKI during colistin treatment.
Characteristics
Total (n = 412)
AKI (n = 282)
Non-AKI (n = 130)
value
Age (years)a
61.5 ± 18.9
65.6 ± 17.1
52.6 ± 19.7
<0.001
Male, n (%)
247 (60.2)
172 (61.0)
75 (57.7)
0.646
Actual BW (kg)a
55.8 ± 13.2
55.5 ± 12.5
56.5 ± 14.6
0.456
IBW (kg)a
58.4 ± 9.47
57.8 ± 9.46
59.4 ± 9.42
0.111
BMI (kg/m2)a
21.5 ± 4.78
21.5 ± 4.61
21.5 ± 5.14
0.892
Underlying disease, n (%)
Hypertension
134 (32.5)
104 (36.9)
30 (23.1)
0.005
CKD
96 (23.3)
79 (28.0)
17 (13.1)
0.001
Diabetes mellitus
90 (21.8)
73 (25.9)
17 (13.1)
0.003
Coronary artery disease
41 (9.95)
38 (13.5)
3 (2.31)
<0.001
On respirator, n (%)
251 (60.9)
173 (61.7)
78 (60.0)
0.794
SOFA scoreb
4.5 (2–7)
5 (3–7)
4 (2–6)
0.004
Septic shock, n (%)
89 (21.6)
67 (23.8)
22 (16.9)
0.117
Concomitant drugs, n (%)
Vancomycin
152 (36.9)
121 (42.9)
31 (23.9)
<0.001
Diuretics
110 (26.7)
87 (30.9)
23 (17.7)
0.005
Vasopressors
102 (24.8)
79 (28.0)
23 (17.7)
0.024
Radiological contrast media
23 (5.58)
18 (6.38)
5 (3.85)
0.297
Amphotericin B
19 (4.61)
15 (5.32)
4 (3.08)
0.313
NSAIDS
6 (1.46)
4 (1.42)
2 (1.54)
1.000
Aminoglycoside
9 (2.18)
7 (2.48)
2 (1.54)
0.726
ACEI
8 (1.94)
7 (2.48)
1 (0.77)
0.444
ARB
1 (0.24)
1 (0.35)
0 (0)
1.000
Number of concomitant drugs, n (%)
<0.001
1 concomitant drug
147 (35.7)
102 (36.2)
45 (34.6)
2 concomitant drugs
86 (20.9)
74 (26.2)
12 (9.23)
3 concomitant drugs
29 (7.04)
23 (8.16)
6 (4.62)
4 concomitant drugs
6 (1.46)
5 (1.77)
1 (0.77)
Baseline laboratory
Hemoglobin (g/dL)a
9.39 ± 1.69
9.29 ± 1.67
9.59 ± 1.73
0.095
Serum albumin (g/dL)a
2.64 ± 0.69
2.60 ± 0.71
2.74 ± 0.63
0.046
Total bilirubin (mg/dL)b
2.17 ± 5.04
2.52 ± 5.86
1.42 ± 2.28
0.040
Mean serum creatinine (mg/dL)a
1.16 ± 1.08
1.25 ± 1.11
0.97 ± 1.00
0.015
Median serum creatine (mg/dL)b
0.8 (0.6–1.3)
0.9 (0.6–1.5)
0.67 (0.5–1.1)
0.015
eGFR (mL/min/1.73 m2)a
82.5 ± 40.2
75.9 ± 37.9
96.8 ± 41.6
<0.001
Severe sepsis, n (%)
Lactate >18 mg/dL
75 (18.2)
60 (21.3)
15 (11.5)
0.017
Baseline eGFR <60 ml/min/1.73m2, n (%)
127 (30.8)
100 (35.5)
27 (20.8)
0.005
AKI before colistin administration
31 (7.52)
20 (7.10)
11 (8.46)
AKI on top CKD
87 (21.1)
80 (28.4)
7 (5.38)
CKD without AKI
9 (2.18)
0 (0)
9 (6.92)
Oliguria ≥2 hours before colistin, n (%)
10 (2.43)
10 (3.55)
0 (0)
0.030
Site of infection, n (%)
Pneumonia
288 (69.9)
196 (69.5)
92 (70.8)
0.795
Urinary tract infection
36 (8.74)
27 (9.57)
9 (6.92)
0.376
Septicemia
35 (8.50)
23 (8.16)
12 (9.23)
0.716
Soft tissue infection
75 (18.2)
52 (18.4)
23 (17.7)
0.855
Type of microorganism, n (%)
Acinetobacter baumannii (MDR)
268 (65.1)
186 (66.0)
82 (63.1)
0.569
Pseudomonas aeruginosa (MDR)
49 (11.9)
35 (12.4)
14 (10.8)
0.632
Klebsiella pneumonia (MDR)
19 (4.61)
14 (4.96)
5 (3.85)
0.802
Note.aMean ± SD, SD; standard deviation, bmedian (interquartile range: IQR). AKI: acute kidney injury, IBW: ideal body weight, BMI: body mass index, CKD: chronic kidney disease, SOFA: sequential organ failure assessment, ACEI: angiotensin-converting enzyme inhibitors, ARB: angiotensin II receptor blockers, NSAIDs: nonsteroidal anti-inflammatory drugs, GFR: glomerular filtration rate, and MDR: multidrug-resistant.
