Kidney Res Clin Pract.  2016 Dec;35(4):229-232. 10.1016/j.krcp.2016.07.005.

Comparison of clinical characteristics of patients with acute kidney injury after intravenous versus inhaled colistin therapy

• Cho AY
• Yoon HJ
• Lee JC
• Kwak JY
• Lee KY
• Sun IO

• KMID: 2364287
• DOI: http://doi.org/10.1016/j.krcp.2016.07.005

Abstract

BACKGROUND
The aim of this study was to investigate the incidence and clinical characteristics of intravenous (IV) or inhaled (IH) colistin-associated acute kidney injury (AKI) using the Risk, Injury, Failure, Loss, End-stage Renal Disease criteria.
METHODS
From 2010 to 2014, 160 patients were treated with IV or IH colistin. Of these, we included 126 patients who received colistin for > 72 hours for the treatment of pneumonia and compared the incidence and clinical characteristics of patients in the IV (n = 107) and IH (n = 19) groups.
RESULTS
The patients included 104 men and 22 women, with a mean age of 69 years (range, 24-91 years). The mortality rate was 45%, and AKI occurred in 75 (60%) patients. At the end of therapy, the bacteriologic cure rate was 66%. There were no differences in the clinical characteristics between the IV and IH groups except for age. In comparison with patients in the IV group, the patients in the IH group were older (74 ± 8 vs. 68 ± 12 years, P = 0.026). The incidence of AKI was not different between the 2 groups (62 vs. 47%, P = not significant), and there was no difference in the severity of AKI according to the Risk, Injury, Failure, Loss, End-stage Renal Disease criteria. Of the 83 patients with AKI, 6 and 1 patients underwent renal replacement therapy, respectively.
CONCLUSION
The incidence of AKI in patients with colistin therapy is 60% in our center. It seems that IH colistin therapy could not be better in safety than IV colistin therapy.

Keyword

Acute kidney injury; Colistin; Inhaler; Intravenous

MeSH Terms

Acute Kidney Injury*
Colistin*
Female
Humans
Incidence
Kidney Failure, Chronic
Male
Mortality
Nebulizers and Vaporizers
Pneumonia
Renal Replacement Therapy
Colistin