Risk factors analysis of drug-induced kidney injury by intravenous polymyxin B
10.3760/cma.j.issn.1671-0282.2023.10.016
- VernacularTitle:静脉用多黏菌素B致药物相关性肾损伤的危险因素分析
- Author:
Hao WU
1
;
Yuan LI
;
Yu ZHOU
;
Jinquan LI
;
Wen LIU
;
Ying ZHOU
;
Guiping JIANG
;
Lili JIANG
;
Hao SUN
Author Information
1. 南京医科大学第一附属医院急诊与危重病医学科，南京 210029
- Keywords:
Polymyxin B;
Drug-induced kidney injruy;
Adverse drug reaction;
Risk factors
- From:
Chinese Journal of Emergency Medicine
2023;32(10):1385-1389
- CountryChina
- Language:Chinese
-
Abstract:
Objective:This study aims to explore the impact of various clinical factors on the risk of polymyxin B induced DKI in patients.Methods:This is a single-center retrospective case-control study. A total of 139 patients receiving polymyxin B intravenous treatment in our hospital from January 1 to December 31, 2020 were collected. Baseline variables between polymyxin B induced DKI group and non-DKI group were compared using the Chi-square test or Fisher's exact test for categorical variables and the T-test or Wilcoxon rank sum test for continuous variables, as appropriate. Statistical analysis was performed using univariate and multivariate Logistic regression models, Logistic regression models, multivariate Logistic regression models, Kaplan Meier curve, as well as Log-Rank test.Results:Among a total of 139 patients receiving polymyxin B treatment, 49 cases have experienced DKI, 90 cases did not. The incidence of DKI was 35.25%. There was no statistical difference in general information of age, gender, and proportion of standard weight between the two groups. Among the related indexes of polycolistin B administration, the proportion of high daily dose [>25 000 U/(kg·d)] and the total dosage of medication in the DKI group were both significantly higher than that in the non-DKI group ( P< 0.05, respectively). Among the organ function indexes, there were significant differences in initial serum creatinine, blood urea nitrogen, uric acid, urinary occult blood and urinary specific gravity between DKI group and non-DKI group 48 hours before polymyxin B administration ( P< 0.05). Binary Logistic regression analysis suggested that daily dose and initial creatinine before medication were independent risk factors for DKI caused by polymyxin B ( P< 0.05). Kaplan-meier survival analysis showed that with the accumulation of Polymyxin B administration, the higher the daily dose of Polymyxin B was, the faster the DKI occurred (Log-Rank P= 0.0194). Conclusions:Using intravenous polymyxin B is associated with the risk of DKI, among which higher initial blood creatinine values and higher daily doses are independent risk factors for DKI.
