title: Emergent renal dysfunction with colistin pharmacotherapy.
abstract: OBJECTIVE
  To evaluate the association between the administration of intravenous (IV) colistin and the emergence of renal dysfunction.
  
  
  METHODS
  A retrospective medical record review.
  
  
  METHODS
  A tertiary care academic medical center.
  
  
  METHODS
  A total of 174 critically ill patients who received at least one dose of IV colistin between 2004 and 2007.
  
  
  RESULTS
  The primary outcome was development of renal dysfunction, defined as an increase in serum creatinine of 50% or more during therapy or the initiation of renal replacement therapy (RRT), in patients who received at least one dose of colistin and were not already on RRT. The severity of renal dysfunction was further categorized by the RIFLE criteria. Demographic and clinical characteristics were analyzed by logistic regression for association with new renal dysfunction. A total of 174 patients were evaluated for renal dysfunction. Of these patients, 84 (48%) experienced renal dysfunction on colistin. On multivariate analysis, age in years (odds ratio [OR] 1.03, 95% confidence interval [CI] 1.01-1.05) and receipt of concurrent nephrotoxin(s) (OR 3.35, 95% CI 1.34-8.36) significantly increased the risk of developing renal dysfunction.
  
  
  CONCLUSIONS
  In this critically ill population, renal dysfunction occurred frequently and was associated with older age and receipt of nephrotoxins.
authors.affiliation: Temple University Hospital, Philadelphia, Pennsylvania, USA.
authors.forename: Julie M
authors.initials: JM
authors.lastname: Collins
authors.forename: Kevin
authors.initials: K
authors.lastname: Haynes
authors.forename: Jason C
authors.initials: JC
authors.lastname: Gallagher
mesh_terms: D018806:APACHE; D000328:Adult; D000367:Age Factors; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D003091:Colistin / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D016001:Confidence Intervals; D003404:Creatinine / Q000097:blood; D016638:Critical Illness; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D007674:Kidney Diseases / Q000139:chemically induced* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D017582:Renal Replacement Therapy; D012189:Retrospective Studies; D012306:Risk; D063128:Tertiary Health Care; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D003404:Creatinine; D003091:Colistin
keywords: Acinetobacter; colistin; gram-negative; multidrug-resistant; polymyxin