Colistin therapy is associated with the development of nephrotoxicity. We examined the incidence and risk factors of nephrotoxicity associated with colistin dosing. We included adult hospitalized patients who received intravenous (IV) colistin for >72 h between January 2014 and December 2015. The primary endpoint was the incidence of colistin-associated acute kidney injury (AKI). The secondary analyses were predictors of nephrotoxicity, proportions of patients inappropriately dosed with colistin according to the Food and Drug Administration (FDA), European Medicines Agency (EMA), and Garonzik formula and clinical cure rate. We enrolled 198 patients with a mean age of 55.67 ± 19.35 years, 62% were men, and 60% were infected with multidrug-resistant organisms. AKI occurred in 44.4% (95% CI: 37.4–51.7). Multivariable analysis demonstrated that daily colistin dose per body weight (kg) was associated with AKI (OR: 1.57, 95% CI: 1.08–2.30; p = 0.02). Other significant predictors included serum albumin level, body mass index (BMI), and severity of illness. None of the patients received loading doses, however FDA-recommended dosing was achieved in 70.2% and the clinical cure rate was 13%. The incidence of colistin-associated AKI is high. Daily colistin dose, BMI, serum albumin level, and severity of illness are independent predictors of nephrotoxicity.

中文翻译：

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Colistin剂量对沙特阿拉伯一家三级医院的肾毒性发生率的影响。

共利斯汀疗法与肾毒性的发展有关。我们检查了与大肠菌素剂量相关的肾毒性的发生率和危险因素。我们纳入了在2014年1月至2015年12月之间接受静脉内（IV）大肠粘菌素治疗的成年住院患者，时间大于72小时。主要终点是大肠粘菌素相关的急性肾损伤（AKI）的发生率。二次分析是预测肾毒性，根据美国食品药品管理局（FDA），欧洲药品管理局（EMA）和Garonzik配方和临床治愈率不适当服用粘菌素的患者比例的预测指标。我们招募了198例平均年龄为55.67±19.35岁的患者，其中62％为男性，60％被耐多药细菌感染。AKI发生率为44.4％（95％CI：37.4-51.7）。p = 0.02）。其他重要的预测指标包括血清白蛋白水平，体重指数（BMI）和疾病严重程度。所有患者均未接受负荷剂量，但是FDA推荐的剂量达到70.2％，临床治愈率为13％。大肠菌素相关性AKI的发生率很高。每日大肠菌素剂量，BMI，血清白蛋白水平和疾病严重程度是肾毒性的独立预测因子。