Evaluation of colistin-associated acute renal failure in intensive care unit

Abstract

Aim: Colistin’s parenteral use was limited due to nephrotoxicity related to decreased renal perfusion, nephrotoxins and ischemiareperfusion injury. Colistin became popular again because of multiple drug resistance. This study aimed to retrospectively evaluate the characteristics of intensive care patient groups with and without colistin-induced acute kidney injury. Material and Methods: Following approval of local ethics committee, information of the patients, who were treated in the anesthesia and surgical intensive care units between 01/01/2016 and 30/06/2017, were analyzed retrospectively. Results: Twenty patients (59%) developed acute kidney injury during colistin treatment. No statistically significant difference was observed between the groups with and without acute kidney injury in terms of age, gender and duration of stay in the intensive care unit, however, patients with acute kidney injury were found to be older and stayed in the intensive care unit for a longer period of time. The comparison made between the groups in terms of inotropic agent use showed that the duration of inotropic agent use was statistically longer in the acute kidney injury group. Discussion: Rate of colistin-induced acute kidney injury varies between 5-55%. In addition, fluid balance of patients is important in acute kidney injury development. Fluid therapy, hourly urine output and central venous pressure trends of the patients should be closely monitored particularly when nephrotoxic medicines are used. There is a need for large-scale studies with more advanced methodologies for the early detection and prevention of colistin-induced nephrotoxicity.