Acute renal failure associated with colistin treatment in the Intensive Care Unit

Abstract

Introduction: The association of colistin and acute kidney injury has shown different results in several studies since the reintroduction of this drug in the common practice. Methods: A prospective and observational study of patients that received treatment with colistin for at least 48 hours in the Intensive Care Unit (ICU) was performed. Results: 104 patients participated in the study, of which 47 % (49) developed acute kidney injury associated to colistin (AKI-C). These patients were grouped according to the RIFLE classification: patients with Risk (10); patients with Injury (13); patients with kidney Failure (26). 6 patients required hemodialysis. The Charlson’s score and the presence of shock were associated to the development of AKI-C. Neither age, APACHE, basal serum creatinine nor accumulated doses of colestin were associated to the development of AKI-C. The AKI-C was associated to a greater in-hospital mortality (p=0.003). Conclusion: The AKI-C is a frequent condition and its associated to a greater in-hospital mortality. The implementation of nephroprotection strategies in patients that receive colestin and the development of new antibiotics with less toxicity could improve the evolution of these patients.

Keywords

• injuria renal aguda
• colistín
• cuidados críticos
• IRA