764. Predictors of colistin-induced acute renal failure
Session: Poster Abstract Session: Antimicrobials: Treatment of HAI and Resistant Infections
Friday, October 4, 2013
Room: The Moscone Center: Poster Hall C
Posters
  • idsa_2013[1].pdf (1.9 MB)
  • Background: The aim of this study was to identify the predictors of acute renal failure associated with colistin treatment.

    Methods: The patients who have received treatment with colistin for more than 3 days were included in this retrospective case-control study. Acute renal failure was defined by the RIFLE criteria. The independent variables determining the development of acute renal failure were investigated by survival analysis.

    Results: Ninety-six cases, 57 (59.4%) of whom were male, were included in the study with a median age 64 (19-93) of years. Nephrotoxicity occured in 52 (54.2%) patients. We identified two independent risk factors predicting acute kolistin-induced renal failure: advanced age (Odds ratio 1.021, 95% confidence interval 1.005-1.037, p=0.011), the rate of increase of serum creatinine level at the third day of colistin treatment (Odds ratio 1.02, 95% confidence interval 1.007-1.034, p=0.003). ROC curve analysis has revealed that the optimum cut-off value of advanced age for the development of acute renal failures was 53.5 years (sensitivity 81%, specificity 47.7%, positive predictive value 58%, negative predictive value 72.4%, area under the ROC curve (AUC)=0.624, p = 0.005) (Figure 1). The optimum cut-off value of rate of increase of serum creatinine level for the development of acute renal failures was 10.5% (sensitivity 76.9%, specificity 67.6%, positive predictive value 71.4%, negative predictive value 73.5%, area under the ROC curve (AUC)=0.705, p = 0.002) (Figure 2) .

    Conclusion : The results of the current study has shown that the advanced age and the rate of increase of serum creatinine level at the third day of colistin treatment are independent variables determining the development of colistin-induced acute renal failure

    Figure 1: Kaplan-Meier curve showing the effect of advanced age on the development of colistin-induced acute renal failure.

    Figure 2: Kaplan-Meier curve showing the effect of increase of serum creatinine level on the development of colistin-induced acute renal failure.

    Bahadir Ceylan1, Mudur Tanis2, Turan Aslan1, Ahmet Cinar3, Yasemin Akkoyunlu1, Ayse Kurt1, Muzaffer Fincanci2, Sule Vatansever4, Didem Ozkan5, Muhammed Akkoyunlu5, Harun Uysal6, Emine Yilmaz6 and Kadir Idin6, (1)Infectious Diseases and Clinical Microbiology, Bezmialem Vakif University, Medical Faculty, Istanbul, Turkey, (2)Infectious Disease and Clinical Microbiology, Istanbul Training and Research Hospital, Istanbul, Turkey, (3)Internal Medicine, Bezmialem Vakif University, Medical Faculty, Istanbul, Turkey, (4)Anestesiology and Reanimation, Istanbul Training and Research Hospital, Istanbul, Turkey, (5)Pulmonary Disease, Bezmialem Vakif University, Medical Faculty, Istanbul, Turkey, (6)Anestesiology and Reanimation, Bezmialem Vakif University, Medical Faculty, Istanbul, Turkey

    Disclosures:

    B. Ceylan, None

    M. Tanis, None

    T. Aslan, None

    A. Cinar, None

    Y. Akkoyunlu, None

    A. Kurt, None

    M. Fincanci, None

    S. Vatansever, None

    D. Ozkan, None

    M. Akkoyunlu, None

    H. Uysal, None

    E. Yilmaz, None

    K. Idin, None

    Findings in the abstracts are embargoed until 12:01 a.m. PST, Oct. 2nd with the exception of research findings presented at the IDWeek press conferences.