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 5
Predictors of total and daily colistin dosages as the risks of acute kidney injury and benefactors of mortality reduction.
OR (95% CI)
Sensitivity (%)
Specificity (%)
PPV (%)
NPV (%)
LRP
LRN
Risks for colistin-induced AKI
Non-AKI before colistin (n = 294)
Daily colistin dose/IBW (AUCROC 0.57)
>4.0 mg/kg/day
2.59 (1.25–5.37)
92.3
17.9
64.5
58.8
1.12
0.43
>4.5 mg/kg/day
1.75 (1.05–2.90)
75.1
36.6
65.7
47.7
1.19
0.68
>5.0 mg/kg/day
1.48 (0.93–2.38)
58.0
51.8
66.0
43.3
1.20
0.81
Daily colistin dose/BW (AUCROC 0.55)
>5.5 mg/kg/day
1.60 (1.00–2.59)
50.0
61.1
67.9
43.1
1.30
0.81
Total colistin dose (AUCROC 0.63)
>1,500 mg
2.49 (1.41–4.40)
85.1
30.4
66.4
55.7
1.22
0.49
>2,000 mg
2.01 (1.19–3.40)
79.0
34.8
66.2
50.6
1.21
0.60
>2,500 mg
3.04 (1.87–4.95)
66.3
60.7
73.2
52.7
1.69
0.56
>3,000 mg
1.95 (1.20–3.19)
48.1
67.9
70.7
44.7
1.50
0.77
Total colistin dose/IBW (AUCROC 0.65)
>45 mg/kg
3.29 (2.02–5.37)
67.2
61.6
73.8
53.9
1.75
0.53
>50 mg/kg
2.68 (1.65–4.37)
58.9
65.2
73.1
49.7
1.69
0.63
AKI before colistin (n = 118)
Total colistin dose (AUCROC 0.62)
>1,000 mg
3.21 (1.18–8.76)
72.0
55.6
90.0
26.3
1.62
0.50
>1,200 mg
2.92 (1.07–7.97)
65.0
61.1
90.3
23.9
1.67
0.57
>1,250 mg
3.74 (1.28–10.9)
59.0
72.2
92.2
24.1
2.12
0.57
>1,350 mg
3.59 (1.23–10.4)
58.0
72.2
92.1
23.6
2.09
0.58
Total colistin dose/IBW (AUCROC 0.61)
>20.0 mg/kg
3.66 (1.30–10.2)
64.6
66.7
91.4
25.5
1.94
0.53
>22.5 mg/kg
3.83 (1.31–11.1)
59.6
72.2
92.2
24.5
2.15
0.56
>23.5 mg/kg
3.12 (1.07–9.04)
54.5
72.2
91.5
22.4
1.96
0.63
>24.0 mg/kg
3.00 (1.03–8.68)
53.5
72.2
91.4
22.0
1.93
0.64
Predictors for improved survival
Non-AKI before colistin (n = 294)
Total colistin dose (AUCROC 0.57)
>1,500 mg
2.20 (1.16–4.17)
89.0
21.4
64.7
54.5
1.13
0.52
>2,000 mg
2.08 (1.23–3.53)
79.6
34.8
66.4
51.3
1.22
0.59
Total colistin dose/IBW (AUCROC 0.57)
>25 mg/kg
2.21 (1.19–4.11)
87.8
23.4
65.2
54.2
1.15
0.52
>30 mg/kg
1.84 (1.07–3.17)
80.7
30.6
65.5
49.3
1.16
0.63
>35 mg/kg
2.20 (1.33–3.66)
75.7
41.4
67.8
51.1
1.29
0.59
Note. OR: odd ratio, PPV: positive predictive value, NPV: negative predictive value, LRP: likelihood ratio for positive results, and LRN: likelihood ratio for negative results.
