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 4
Comparison of colistin dosage, length of hospital stay, and death outcomes between AKI and non-AKI groups.
Characteristic
Colistin-induced AKI
No colistin-induced AKI
Total AKI (n = 282)
AKI-naïve (n = 182)
AKI before colistin and worsening during colistin Rx (n = 100)
value
Total non-AKI (n = 130)
No AKI before and during colistin treatment (n = 112)
AKI before colistin but no worsening during colistin Rx (n = 18)
value
Body weight (kg)
55.5 ± 12.5
54.8 ± 12.6
56.8 ± 12.3
0.20
56.5 ± 14.6
56.8 ± 15.2
54.8 ± 10.1
0.59
Ideal body weight (kg)
57.8 ± 9.46
57.6 ± 9.06
58.2 ± 10.2
0.63
59.4 ± 9.42
59.8 ± 9.69
57.3 ± 7.44
0.30
Serum creatinine before treatment with colistin (mg/dL)
1.23 ± 1.09,#,$
0.68 ± 0.24,$
2.23 ± 1.32,#
<0.001
0.97 ± 1.00
0.76 ± 0.55
2.26 ± 1.88
<0.001
Serum creatinine at time off colistin (mg/dL)
2.37 ± 1.42,#
1.94 ± 1.20,#
3.16 ± 1.45,#,$
<0.001
0.92 ± 0.88
0.74 ± 0.38
2.02 ± 1.85
<0.001
Colistin treatment and dosing
Loading of colistin, n (%)
253 (89.7)
159 (87.4)
94 (94.0)
0.08
120 (92.3)
102 (91.1)
18 (100)
0.36
Loading dose (mg)
292 ± 33.1
297 ± 20.5
284 ± 46.3,#
0.003
296 ± 24.6
296 ± 22.3
292 ± 35.4
0.45
Loading dose/BW (mg/kg)
5.52 ± 1.31
5.70 ± 1.34
5.20 ± 1.22
0.003
5.52 ± 1.28
5.53 ± 1.30
5.48 ± 1.19
0.88
Loading dose/IBW (mg/kg)
5.22 ± 1.07
5.32 ± 0.96
5.03 ± 1.21
0.036
5.11 ± 0.95
5.10 ± 0.95
5.17 ± 0.93
0.78
Daily dose (mg/day)a
253 ± 80.2,#,$
294 ± 37.1,$
178 ± 83.3,#
<0.001
272 ± 66.6
286 ± 51.9
185 ± 81.9
<0.001
Daily dose/BW (mg/kg/day)a
4.77 ± 1.85#,$
5.63 ± 1.41,$
3.20 ± 1.52,#
<0.001
5.03 ± 1.61
5.30 ± 1.49
3.35 ± 1.35
<0.001
Daily dose/IBW (mg/kg/day)a
4.50 ± 1.61#,$
5.23 ± 1.05,#,$
3.17 ± 1.63,#
<0.001
4.66 ± 1.31
4.89 ± 1.16
3.22 ± 1.32
<0.001
Total dose of colistin (mg)a
2,852 ± 2,009$
3,529 ± 2,095,#,$
1,627 ± 1,038,#
<0.001
2,506 ± 1,662
2,693 ± 1,662
1,342 ± 1,121
0.001
Total dose of colistin/BW (mg/kg)a
53.3 ± 36.6$
66.6 ± 37.3,#,$
29.2 ± 18.8,#
<0.001
46.4 ± 33.8
49.9 ± 34.3
24.9 ± 19.3
0.003
Total dose of colistin/IBW (mg/kg)a
50.8 ± 39.0, $
63.2 ± 41.8,#,$
28.4 ± 18.0,#
<0.001
43.2 ± 31.0
46.3 ± 31.5
23.9 ± 19.3
0.004
Duration of colistin treatment (days)a
10 (7–14),#,$
10 (7–14),#,$
7.5 (5.5–14)$
0.001
7 (5–14)
7 (5–14)
4.5 (3–14)
0.08
Microbiological eradication, n (%)
180 (63.8)
122 (67.0)
58 (58.0)#
0.19
92 (70.8)
84 (75.0)
8 (44.4)
0.042
Length of stay (days)b
40 (25–59)
40 (25–60)
39.5 (26–58)
0.85
35 (20–61)
34.5 (20–61)
36 (24–68)
0.76
Death within days 28 of admission, n (%)
57 (20.2)#
36 (19.8)
21 (21.0)
0.81
16 (12.3)
13 (11.6)
3 (16.7)
0.47
Mortality rate, n (%)
137 (48.6),#
80 (44.0),#
57 (57.0),#
0.036
40 (30.8)
33 (29.5)
7 (38.9)
0.42
Note.aMean ± SD, SD; standard deviation, bmedian (interquartile range: IQR), AKI: acute kidney injury, BW: body weight, and IBW: ideal body weight. values <0.05; vs. total non-AKI group, #vs. no AKI before and during colistin treatment group, and $vs. AKI before colistin but no worsening during colistin treatment group.