Research Article

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.

CharacteristicColistin-induced AKINo colistin-induced AKI
Total AKI (n = 282)AKI-naïve (n = 182)AKI before colistin and worsening during colistin Rx (n = 100) valueTotal 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 ± 12.554.8 ± 12.656.8 ± 12.30.2056.5 ± 14.656.8 ± 15.254.8 ± 10.10.59
Ideal body weight (kg)57.8 ± 9.4657.6 ± 9.0658.2 ± 10.20.6359.4 ± 9.4259.8 ± 9.6957.3 ± 7.440.30
Serum creatinine before treatment with colistin (mg/dL)1.23 ± 1.09,#,$0.68 ± 0.24,$2.23 ± 1.32,#<0.0010.97 ± 1.000.76 ± 0.552.26 ± 1.88<0.001
Serum creatinine at time off colistin (mg/dL)2.37 ± 1.42,#1.94 ± 1.20,#3.16 ± 1.45,#,$<0.0010.92 ± 0.880.74 ± 0.382.02 ± 1.85<0.001
Colistin treatment and dosing
 Loading of colistin, n (%)253 (89.7)159 (87.4)94 (94.0)0.08120 (92.3)102 (91.1)18 (100)0.36
  Loading dose (mg)292 ± 33.1297 ± 20.5284 ± 46.3,#0.003296 ± 24.6296 ± 22.3292 ± 35.40.45
  Loading dose/BW (mg/kg)5.52 ± 1.315.70 ± 1.345.20 ± 1.220.0035.52 ± 1.285.53 ± 1.305.48 ± 1.190.88
  Loading dose/IBW (mg/kg)5.22 ± 1.075.32 ± 0.965.03 ± 1.210.0365.11 ± 0.955.10 ± 0.955.17 ± 0.930.78
 Daily dose (mg/day)a253 ± 80.2,#,$294 ± 37.1,$178 ± 83.3,#<0.001272 ± 66.6286 ± 51.9185 ± 81.9<0.001
 Daily dose/BW (mg/kg/day)a4.77 ± 1.85#,$5.63 ± 1.41,$3.20 ± 1.52,#<0.0015.03 ± 1.615.30 ± 1.493.35 ± 1.35<0.001
 Daily dose/IBW (mg/kg/day)a4.50 ± 1.61#,$5.23 ± 1.05,#,$3.17 ± 1.63,#<0.0014.66 ± 1.314.89 ± 1.163.22 ± 1.32<0.001
 Total dose of colistin (mg)a2,852 ± 2,009$3,529 ± 2,095,#,$1,627 ± 1,038,#<0.0012,506 ± 1,6622,693 ± 1,6621,342 ± 1,1210.001
 Total dose of colistin/BW (mg/kg)a53.3 ± 36.6$66.6 ± 37.3,#,$29.2 ± 18.8,#<0.00146.4 ± 33.849.9 ± 34.324.9 ± 19.30.003
 Total dose of colistin/IBW (mg/kg)a50.8 ± 39.0, $63.2 ± 41.8,#,$28.4 ± 18.0,#<0.00143.2 ± 31.046.3 ± 31.523.9 ± 19.30.004
 Duration of colistin treatment (days)a10 (7–14),#,$10 (7–14),#,$7.5 (5.5–14)$0.0017 (5–14)7 (5–14)4.5 (3–14)0.08
Microbiological eradication, n (%)180 (63.8)122 (67.0)58 (58.0)#0.1992 (70.8)84 (75.0)8 (44.4)0.042
Length of stay (days)b40 (25–59)40 (25–60)39.5 (26–58)0.8535 (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)0.8116 (12.3)13 (11.6)3 (16.7)0.47
Mortality rate, n (%)137 (48.6),#80 (44.0),#57 (57.0),#0.03640 (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.