Infection and Drug Resistance (Apr 2022)

Risk Factors for Acute Kidney Injury Induced by Intravenous Polymyxin B in Chinese Patients with Severe Infection

  • Jia X,
  • Guo C,
  • Yin Z,
  • Zhang W,
  • Du S,
  • Zhang X

Journal volume & issue
Vol. Volume 15
pp. 1957 – 1965

Abstract

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Xuedong Jia,1,2 Cuohui Guo,1 Zhao Yin,1,2 Wan Zhang,1,2 Shuzhang Du,1,2 Xiaojian Zhang1,2 1Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China; 2The Precision Clinical Pharmacy Key Laboratory of Henan Province, Zhengzhou, People’s Republic of ChinaCorrespondence: Xuedong Jia; Shuzhang Du, Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China, Email [email protected]; [email protected]: To analyze the risk factors for acute kidney injury (AKI) induced by intravenous polymyxin B in Chinese patients with severe infection and to provide a reference for clinicians and pharmacists.Methods: We retrospectively analyzed patients treated with intravenous polymyxin B from August 2018 to August 2020 in a Chinese teaching hospital. Renal function was evaluated during therapy with polymyxin B and at the end of the treatment. Univariate and multivariate analyses were conducted to determine risk factors for the nephrotoxicity of polymyxin B.Results: A total of 321 patients were included, and the incidence of AKI was 26.2% and 25.1% during polymyxin B therapy and at the end of treatment, respectively. Independent risk factors for AKI during therapy with polymyxin B were septic shock, coadministration of vancomycin or loop diuretics, and advanced age (≥ 60 years), while the incidence of AKI during treatment with polymyxin B was considered to be an independent risk factor for AKI at the end of the treatment.Conclusion: Septic shock, coadministration of vancomycin or loop diuretics, and advanced age (age ≥ 60 years) were found to be risk factors for AKI induced by intravenous polymyxin B. Clinicians and pharmacists should consider these factors when designing and recommending treatment with polymyxin B.Keywords: polymyxin B, acute kidney injury, risk factors, anti-infective therapy

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