Factors Affecting the Colistin Nephrotoxicity: Advanced Age and/or Other Factors?

Introduction: The population is aging, and older adults comprise most patients in the intensive care units. Colistin (COL) has been re-introduced to treat increasingly common resistant Gram-negative bacterial infections. Our study aims to investigate the factors affecting COL nephrotoxicity in a gen...

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Main Authors: Tuğba ARSLAN GÜLEN, Ayfer İMRE, Üner KAYABAŞ
Format: Article
Language:Turkish
Published: Galenos Yayinevi 2022-04-01
Series:Mediterranean Journal of Infection, Microbes and Antimicrobials
Subjects:
Online Access:http://mjima.org/text.php?&id=310
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author Tuğba ARSLAN GÜLEN
Ayfer İMRE
Üner KAYABAŞ
author_facet Tuğba ARSLAN GÜLEN
Ayfer İMRE
Üner KAYABAŞ
author_sort Tuğba ARSLAN GÜLEN
collection DOAJ
description Introduction: The population is aging, and older adults comprise most patients in the intensive care units. Colistin (COL) has been re-introduced to treat increasingly common resistant Gram-negative bacterial infections. Our study aims to investigate the factors affecting COL nephrotoxicity in a general population and geriatric age group. Materials and Methods: This retrospective study included 170 patients, a total of 116 (68.2%) of whom were in the geriatric group (age ≥65). Acute renal failure was evaluated using the RIFLE score. Factors associated with COL nephrotoxicity were described firstly in a general population and then in the geriatric group patients. Results: Advanced age [Odds ratio (OR): 1.043; 95% confidence interval (CI): 1.018-1.068; p=0.001] and initial serum creatinine level (OR: 23.122; 95% CI: 3.123-171.217; p=0.002) were found to be the independent risk factors associated with nephrotoxicity. In the evaluation of the geriatric population based on nephrotoxicity, the initial serum urea and creatinine levels, and overall mortality rates were found to be statistically significantly higher in the group with nephrotoxicity (p<0.05). Initial serum creatinine level (OR: 22.48; 95% CI: 2.835-178.426; p=0.003) and concomitant nephrotoxic agent use (OR: 2.516; 95% CI: 1.275-4.963; p=0.008) were independent risk factors associated with nephrotoxicity in geriatric patients. Conclusion: Advanced age was found to be a risk factor for COL nephrotoxicity. Closed observation should be done especially in the geriatric patients who have initial serum creatinine levels close to the upper limit, concomitant use of the nephrotoxic drugs should be avoided, and if possible, evaluation should be made in terms of non-COL treatment options in these patients.
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spelling doaj.art-1ab2b1f07f1b4c15b351fab013c8a5772023-02-15T16:09:02ZturGalenos YayineviMediterranean Journal of Infection, Microbes and Antimicrobials2147-673X2022-04-0111110.4274/mjima.galenos.2022.2021.13Factors Affecting the Colistin Nephrotoxicity: Advanced Age and/or Other Factors? Tuğba ARSLAN GÜLEN0https://orcid.org/0000-0001-5706-9824Ayfer İMRE1https://orcid.org/0000-0002-1885-8895Üner KAYABAŞ2https://orcid.org/0000-0002-5323-0796Niğde Ömer Halisdemir University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Niğde, TurkeyNiğde Training and Research Hospital, Clinic of Infectious Diseases and Clinical Microbiology, Niğde, TurkeyNiğde Ömer Halisdemir University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Niğde, TurkeyIntroduction: The population is aging, and older adults comprise most patients in the intensive care units. Colistin (COL) has been re-introduced to treat increasingly common resistant Gram-negative bacterial infections. Our study aims to investigate the factors affecting COL nephrotoxicity in a general population and geriatric age group. Materials and Methods: This retrospective study included 170 patients, a total of 116 (68.2%) of whom were in the geriatric group (age ≥65). Acute renal failure was evaluated using the RIFLE score. Factors associated with COL nephrotoxicity were described firstly in a general population and then in the geriatric group patients. Results: Advanced age [Odds ratio (OR): 1.043; 95% confidence interval (CI): 1.018-1.068; p=0.001] and initial serum creatinine level (OR: 23.122; 95% CI: 3.123-171.217; p=0.002) were found to be the independent risk factors associated with nephrotoxicity. In the evaluation of the geriatric population based on nephrotoxicity, the initial serum urea and creatinine levels, and overall mortality rates were found to be statistically significantly higher in the group with nephrotoxicity (p<0.05). Initial serum creatinine level (OR: 22.48; 95% CI: 2.835-178.426; p=0.003) and concomitant nephrotoxic agent use (OR: 2.516; 95% CI: 1.275-4.963; p=0.008) were independent risk factors associated with nephrotoxicity in geriatric patients. Conclusion: Advanced age was found to be a risk factor for COL nephrotoxicity. Closed observation should be done especially in the geriatric patients who have initial serum creatinine levels close to the upper limit, concomitant use of the nephrotoxic drugs should be avoided, and if possible, evaluation should be made in terms of non-COL treatment options in these patients.http://mjima.org/text.php?&id=310colistinnephrotoxicitygeriatric patientintensive care unit
spellingShingle Tuğba ARSLAN GÜLEN
Ayfer İMRE
Üner KAYABAŞ
Factors Affecting the Colistin Nephrotoxicity: Advanced Age and/or Other Factors?
Mediterranean Journal of Infection, Microbes and Antimicrobials
colistin
nephrotoxicity
geriatric patient
intensive care unit
title Factors Affecting the Colistin Nephrotoxicity: Advanced Age and/or Other Factors?
title_full Factors Affecting the Colistin Nephrotoxicity: Advanced Age and/or Other Factors?
title_fullStr Factors Affecting the Colistin Nephrotoxicity: Advanced Age and/or Other Factors?
title_full_unstemmed Factors Affecting the Colistin Nephrotoxicity: Advanced Age and/or Other Factors?
title_short Factors Affecting the Colistin Nephrotoxicity: Advanced Age and/or Other Factors?
title_sort factors affecting the colistin nephrotoxicity advanced age and or other factors
topic colistin
nephrotoxicity
geriatric patient
intensive care unit
url http://mjima.org/text.php?&id=310
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