EVALUATION OF DAILY CHANGES OF GLOMERULAR FILTRATION RATES IN PATIENTS RECEIVING COLISTIN DUE TO ACINETOBACTER INFECTION IN INTENSIVE CARE UNITE

Ayse Sahin Tutak*, Hakan Sezgin Saymer and Serdar Olt

ABSTRACT

Aim: To examine relationship between the frequency of secondary nephrotoxicity, mortality rates and daily glomerular filtration rate [GFR] in patients receiving colistin due to acinetobacter infection in Intensive Care Unit [ICU] at the Adıyaman University Medical Faculty Hospital, Adıyaman, Turkey. Materials and Methods: Twenty-nine patients receiving colistin for at least 3 days due to acinetobacter infection were included in the study between the dates of January 2014 and January 2016. Age, gender, hospitalization period, the date of positive culture, hospitalization diagnosis, laboratory parameters and patients’ survival condition were documented from the hospital records. GFR was calculated by Modification of Diet in Renal Disease [MDRD] formulation at the initial day and third day of colistin and creatine levels of patients were recorded for 3 days. Patients having creatinine level of more than 1.5 prior to initiation of colistin and patients receiving renal replacement therapy were excluded from the study. Double serum creatinine after therapy and/or 50% reduction of GFR values were defined as renal function disorder or nephrotoxicity. Results: Of the patients, 14 were male and 15 were female. The mean age of patients was 72.1±18.7. A statistically significant reduction was detected in daily GFR values [p<0.01]. Among the 29 patients, 24 died. The mean hospitalization period of patients was 27.7±13.5. Renal function disorder was detected in 16 [55.1%] of patients. Conclusion: Nephrotoxic effect of colistin was shown in various studies. However there isn’t any data in the literature about the daily GFR observation in the detection of the colistin nephrotoxicity. Thus herein we examined nephrotoxicity rates by daily GFR values for the first time in the literature. The rates of nephrotoxicity were 55,1%.

Keywords: Colistin, acinetobacter, nephrotoxicity, glomerular filtration rate, creatinine.