A single-centered study of factors affecting colistin related nephropathy

  • Authors

    • Güzin Çakmak Gaziantep University, Faculty of Medicine, Department of Internal Medicine, Division of Geriatrics
    • Zeynel Abidin Öztürk Gaziantep University, Faculty of Medicine, Department of Internal Medicine, Division of Geriatrics
    2020-07-25
    https://doi.org/10.14419/ijm.v8i1.30755
  • Colistin, Nephropathy, Colistin Nephropathy, Colistin Related Nephropathy.
  • Abstract

    Background: Colistin is an old antibiotic and used for resistant gram-negative infections. Nephrotoxicity is the most common side effect and restricts clinicians to use it. Many risk factors suggested for the development of nephropathy. It could be better to know risks to prevent nephropathy development. Objectives: In this study, we aimed to evaluate factors that affecting the development of nephropathy in patients who were hospitalized in hematology, oncology, palliative care, and intensive care units. Methods: 125 patients aged 20-93 years old were enrolled in this retrospective study. Data were obtained from the pharmacy of the university hospital and information management system of the hospital. Results: Among 125 patients included in the study, 15 developed KDIGO stage 1 nephropathy, 21 stages two nephropathies, and four stages three nephropathies, respectively. Age, albumin level, and bilirubin levels were shown to be related to nephropathy. We found the cut off value of albumin 3.05 mg/dl for development of nephropathy (sensitivity 70%; specificity 66%; CI=95%, p=0.003) and mortality (sensitivity 69%; specificity 61%; CI=95%, p<0.001). We revealed that age and bilirubin levels independently affected the development of nephropathy in linear regression analysis (r2 =0.131, p=0.032; p=0.015). Also, mortality was denoted to be related to albumin and bilirubin levels independently in linear regression analysis (r2 =0.161, p=0.03; p=0.004). Conclusions: Older age, hypoalbuminemia, and hyperbilirubinemia were risk factors for colistin related nephropathy and mortality. Further studies will be better to elucidate relationships more clearly.

     

     

     


  • References

    1. [1] &NA; 2005. “Colistin: The Revival of Polymyxins for the Management of Multidrug-Resistant Gram-Negative Bacterial Infections.†The Pediatric Infectious Disease Journal 24(10): 945. https://doi.org/10.1097/01.inf.0000174577.97635.7b.

      [2] Acta, J Biochim Biophys, Melvin Schindler, and M J Osborn. 1979. “Interaction of Divalent Cations and Polymyxin B With.†18(20): 4425–30. https://doi.org/10.1021/bi00587a024.

      [3] Ahmed, M. S., A. B. Jadhav, A. Hassan, and Qing H. Meng. 2012. “Acute Phase Reactants as Novel Predictors of Cardiovascular Disease.†ISRN Inflammation 2012: 1–18. https://doi.org/10.5402/2012/953461.

      [4] De Castro, Lais Lima et al. 2014. “Hipoalbuminemia y El Estres Oxidativo En Pacientes En Programa de Dialisis Renal.†Nutricion Hospitalaria 30(4): 952–59.

      [5] Çetin, Çiğdem Banu et al. 2016. “Colistin Efficacy in the Treatment of Multidrug-Resistant and Extremely Drug-Resistant Gram-Negative Bacterial Infections.†Turkish Journal of Medical Sciences 46(5): 1379–84. https://doi.org/10.3906/sag-1506-125.

      [6] Clarke, K., G. W. Gray, and D. A. Reaveley. 1967. “The Cell Walls of Pseudomonas Aeruginosa. General Composition.†The Biochemical journal 105(2): 749–54. https://doi.org/10.1042/bj1050749.

      [7] Clifton, Luke A. et al. 2015. “Effect of Divalent Cation Removal on the Structure of Gram-Negative Bacterial Outer Membrane Models.†Langmuir 31(1): 404–12. https://doi.org/10.1021/la504407v.

      [8] Das, Parijat, Gaurav Goel, and Sanjay Bhattacharya. 2018. “Official Publication of Academy of Clinical Microbiologists.†(January).

      [9] Gai, Zhibo, Sophia L. Samodelov, Gerd A. Kullak-Ublick, and Michele Visentin. 2019. “Molecular Mechanisms of Colistin-Induced Nephrotoxicity.†Molecules (Basel, Switzerland) 24(3). https://doi.org/10.3390/molecules24030653.

      [10] Giacobbe, Daniele Roberto et al. 2018. “Hypoalbuminemia as a Predictor of Acute Kidney Injury during Colistin Treatment.†Scientific Reports 8(1): 1–11. https://doi.org/10.1038/s41598-018-30361-5.

      [11] Hachem, Ray Y. et al. 2007. “Colistin Is Effective in Treatment of Infections Caused by Multidrug-Resistant Pseudomonas Aeruginosa in Cancer Patients.†Antimicrobial Agents and Chemotherapy 51(6): 1905–11. https://doi.org/10.1128/AAC.01015-06.

      [12] Jain, Koyal et al. 2015. “Bile Cast Nephropathy.†Kidney International 87(2): 484. https://doi.org/10.1038/ki.2014.233.

      [13] Jellinge, Marlene Ersgaard, Daniel Pilsgaard Henriksen, Peter Hallas, and Mikkel Brabrand. 2014. “Hypoalbuminemia Is a Strong Predictor of 30-Day All-Cause Mortality in Acutely Admitted Medical Patients: A Prospective, Observational, Cohort Study.†PLoS ONE 9(8): 8–12. https://doi.org/10.1371/journal.pone.0105983.

      [14] Kim, Eun Jung, and Eu Suk Kim. 2018. “Exploring New Predictors of Colistin-Associated Nephrotoxicity.†Infection and Chemotherapy 50(3): 283–85. https://doi.org/10.3947/ic.2018.50.3.283.

      [15] Kim, Jieun, Kyoung Ho Lee, Sunmi Yoo, and Hyunjoo Pai. 2009. “Clinical Characteristics and Risk Factors of Colistin-Induced Nephrotoxicity.†International Journal of Antimicrobial Agents 34(5): 434–38. https://doi.org/10.1016/j.ijantimicag.2009.06.028.

      [16] Kwon, Jeong Ah et al. 2010. “Predictors of Acute Kidney Injury Associated with Intravenous Colistin Treatment.†International Journal of Antimicrobial Agents 35(5): 473–77. https://doi.org/10.1016/j.ijantimicag.2009.12.002.

      [17] Lim, Lauren M et al. 2015. “HHS Public Access.†30(12): 1279–91.

      [18] Machado, Maurício Nassau, Marcelo Arruda Nakazone, and Lilia Nigro Maia. 2014. “Lesão Renal Aguda Baseada Nos Critérios KDIGO (Kidney Disease: Improving Global Outcomes) Em Pacientes Com Creatinina Sérica Elevada Submetidos à Cirurgia Cardíaca.†Brazilian Journal of Cardiovascular Surgery 29(3): 299–307.

      [19] Mohamed, Ami F. et al. 2012. “Application of a Loading Dose of Colistin Methanesulfonate in Critically Ill Patients: Population Pharmacokinetics, Protein Binding, and Prediction of Bacterial Kill.†Antimicrobial Agents and Chemotherapy 56(8): 4241–49. https://doi.org/10.1128/AAC.06426-11.

      [20] Morrison, David C., and Diane M. Jacobs. 1976. “Binding of Polymyxin B to the Lipid A Portion of Bacterial Lipopolysaccharides.†Immunochemistry 13(10): 813–18. https://doi.org/10.1016/0019-2791(76)90181-6.

      [21] O’Driscoll, Noëlle H., T. P.Tim Cushnie, Kerr H. Matthews, and Andrew J. Lamb. 2018. “Colistin Causes Profound Morphological Alteration but Minimal Cytoplasmic Membrane Perforation in Populations of Escherichia Coli and Pseudomonas Aeruginosa.†Archives of Microbiology 200(5): 793–802. https://doi.org/10.1007/s00203-018-1485-3.

      [22] Shields, Ryan K. et al. 2017. “Defining the Incidence and Risk Factors of Colistin-Induced Acute Kidney Injury by KDIGO Criteria.†PLoS ONE 12(3): 3–7. https://doi.org/10.1371/journal.pone.0173286.

      [23] Suzuki, Takahiro et al. 2013. “Megalin Contributes to Kidney Accumulation and Nephrotoxicity of Colistin.†Antimicrobial Agents and Chemotherapy 57(12): 6319–24. https://doi.org/10.1128/AAC.00254-13.

      [24] Taverna, Myriam, Anne Lise Marie, Jean Paul Mira, and Bertrand Guidet. 2013. “Specific Antioxidant Properties of Human Serum Albumin.†Annals of Intensive Care 3(1): 1–7. Annals of Intensive Care. https://doi.org/10.1186/2110-5820-3-4.

      [25] Wardle, E. N. 1975. “Renal Failure in Obstructive Jaundice-Pathogenic Factors.†Postgraduate Medical Journal 51(598): 512–14. https://doi.org/10.1136/pgmj.51.598.512.

      [26] Wiedermann, Christian J, Wolfgang Wiedermann, and Michael Joannidis. 2017. “Causal Relationship between Hypoalbuminemia and Acute Kidney Injury.†World Journal of Nephrology 6(4): 176. https://doi.org/10.5527/wjn.v6.i4.176.

      [27] Yu, Zhiliang, Zhongqi Sun, Jianhua Yin, and Juanping Qiu. 2018. “Enhanced Production of Polymyxin E in Paenibacillus Polymyxa by Replacement of Glucose by Starch.†BioMed Research International 2018. https://doi.org/10.1155/2018/1934309.

  • Downloads

  • How to Cite

    Çakmak, G., & Abidin Öztürk, Z. (2020). A single-centered study of factors affecting colistin related nephropathy. International Journal of Medicine, 8(1), 13-17. https://doi.org/10.14419/ijm.v8i1.30755

    Received date: 2020-05-17

    Accepted date: 2020-07-17

    Published date: 2020-07-25