Pharmacokinetic/Toxicodynamic Analysis of Colistin-Associated Acute Kidney Injury in Critically Ill Patients

Antimicrob Agents Chemother. 2017 Oct 24;61(11):e01367-17. doi: 10.1128/AAC.01367-17. Print 2017 Nov.

Abstract

Acute kidney injury (AKI) occurs in a substantial proportion of critically ill patients receiving intravenous colistin. In the pharmacokinetic/toxicodynamic analysis reported here, the relationship of the occurrence of AKI to exposure to colistin and a number of potential patient factors was explored in 153 critically ill patients, none of whom were receiving renal replacement therapy. Tree-based modeling revealed that the rates of AKI were substantially higher when the average steady-state plasma colistin concentration was greater than ∼2 mg/liter.

Keywords: PK/TD relationship; acute kidney injury; colistin.

Publication types

  • Multicenter Study
  • Observational Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Acute Kidney Injury / chemically induced*
  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / adverse effects
  • Anti-Bacterial Agents / blood
  • Anti-Bacterial Agents / pharmacokinetics*
  • Colistin / adverse effects
  • Colistin / blood
  • Colistin / pharmacokinetics*
  • Creatinine / blood
  • Critical Illness
  • Female
  • Humans
  • Male
  • Middle Aged

Substances

  • Anti-Bacterial Agents
  • Creatinine
  • Colistin