title: Evaluation of Risk Factors for Intravenous Colistin Use-related Nephrotoxicity.
abstract: OBJECTIVE
  We investigated the incidence of and risk factors for nephrotoxicity in patients using intravenous colistin.
  
  
  METHODS
  This retrospective, observational study was conducted at Karadeniz Technical University, Faculty of Medicine, clinics and intensive care unit between 1 January 2009 and 1 January 2013. Intravenous colistin was administered to 133 patients at a dose of 2.5-5.0 mg/kg/day.
  
  
  RESULTS
  The patients mean age was 54.3±19.1 years and the mean duration of treatment was 13.5±3.6 days. Nephrotoxicity developed in 5.0±2.8 days in 38 (28.6%) patients. Based on RIFLE (risk, injury, failure, loss of kidney function, and end-stage kidney disease) criteria, 15 (39.5%) patients were class 1, 17 (44.7%) were class 2, six (15.8%) were class 3, and none were class 4. The mean duration of development of nephrotoxicity was 5.0±2.8 days. Hemodialysis requirement was observed in two (5.2%) of the 38 patients who developed nephrotoxicity. In these cases, colistin therapy was not discontinued. Nephrotoxicity was correlated with advanced age, high pretreatment serum creatinine levels, diabetes mellitus, and chronic obstructive pulmonary disease.
  
  
  CONCLUSIONS
  The use of colistin is relatively safe for patients that have normal renal functions. However, better standardization of the definition of nephrotoxicity in those patients with the use of scoring systems and close monitoring are necessary.
authors.affiliation: Infectious Diseases and Clinical Microbiology, Karadeniz Technical University, School of Medicine, Trabzon, Turkey.
authors.forename: Iftihar
authors.initials: I
authors.lastname: Koksal
authors.affiliation: Infectious Diseases and Clinical Microbiology, Karadeniz Technical University, School of Medicine, Trabzon, Turkey.
authors.forename: Selcuk
authors.initials: S
authors.lastname: Kaya
authors.affiliation: Infectious Diseases and Clinical Microbiology, Karadeniz Technical University, School of Medicine, Trabzon, Turkey.
authors.forename: Eda
authors.initials: E
authors.lastname: Gencalioglu
authors.affiliation: Infectious Diseases and Clinical Microbiology, Karadeniz Technical University, School of Medicine, Trabzon, Turkey.
authors.forename: Gurdal
authors.initials: G
authors.lastname: Yilmaz
keywords: Colistin; Renal Insufficiency; Risk factors