title: [Risk factors for acute kidney injury in patients treated with polymyxin B experience from 139 cases at a tertiary university hospital in Colombia].
abstract: BACKGROUND
  The rise of infections caused by multidrug-resistant Gram negative bacilli (MDR-GNB), added to paucity of newer therapy, have led to increase polymyxin B use, despite adverse renal toxicity profile.
  
  
  OBJECTIVE
  To determine the incidence and risk factors associated to acute kidney injury (AKI) and polymyxin B use, in patients with infections caused by MDR-GNB.
  
  
  METHODS
  A retrospective cohort, with a nested case-control study of adults who received polymyxin B for more than 48 hours at a tertiary university hospital in Colombia (2011-2015) was performed. AKI was defined by AKIN criteria.
  
  
  RESULTS
  Of 139 patients included in our study, 102 were male with median age of 49 years (IQR:28-64). Sixty-one patients (44%) developed AKI. Independent risk factors for development of AKI included: total polymyxin B daily dose (OR = 2.19, 95% CI, 1.04-4.64); length of stay at ICU (OR = 1.03, 95% CI, 1.00-1.06); nosocomial infection (OR = 6.43, 95% CI, 2.12, -19.47); and vasopressor use (OR = 5.38, 95% CI, 2.40-12.07). Mortality was higher among AKI-patients (58.6%) compared with non-AKI patients (25.6%) (p = 0.001).
  
  
  CONCLUSIONS
  In this study, the rate of AKI associated to polymyxin B use was greater than reported in studies from last decade, and associated with increased mortality. AKI associated to polymyxin B use is likely multifactorial and aggravated by the critically ill state of patients suffering nosocomial infections caused by mdr-gnb.
authors.affiliation: Grupo de Investigación Infecto Control, Neiva, Huila, Colombia.
authors.forename: Johanna
authors.initials: J
authors.lastname: Osorio
authors.affiliation: Grupo de Investigación Infecto Control, Neiva, Huila, Colombia.
authors.forename: Jackeline
authors.initials: J
authors.lastname: Barreto
authors.affiliation: Departamento de Epidemiología, Universidad Surcolombiana, Neiva, Huila, Colombia.
authors.forename: Claudia F
authors.initials: CF
authors.lastname: Samboni
authors.affiliation: Departamento de Epidemiología, Universidad Surcolombiana, Neiva, Huila, Colombia.
authors.forename: Lina A
authors.initials: LA
authors.lastname: Cándelo
authors.affiliation: Departamento de Epidemiología, Universidad Surcolombiana, Neiva, Huila, Colombia.
authors.forename: Luis C
authors.initials: LC
authors.lastname: Álvarez
authors.affiliation: Hospital Universitario, Neiva, Huila, Colombia.
authors.forename: Susana
authors.initials: S
authors.lastname: Benavidez
authors.affiliation: Hospital Universitario, Neiva, Huila, Colombia.
authors.forename: Roso P
authors.initials: RP
authors.lastname: Téllez
authors.affiliation: Grupo de Investigación Infecto Control, Neiva, Huila, Colombia.
authors.forename: Dagoberto
authors.initials: D
authors.lastname: Santofimio
authors.affiliation: Grupo de Investigación Infecto Control, Neiva, Huila, Colombia.
authors.forename: Jorge A
authors.initials: JA
authors.lastname: Ramos
authors.affiliation: Grupo de Investigación Infecto Control, Neiva, Huila, Colombia.
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Gómez
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000453:epidemiology; D000328:Adult; D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000627:therapeutic use; D003105:Colombia / Q000453:epidemiology; D004812:Epidemiologic Methods; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011112:Polymyxin B / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D011112:Polymyxin B