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VOLUME 20 , ISSUE 6 ( 2016 ) > List of Articles


The risk factors of colistin methanesulfonate associated nephrotoxicity

Elif Tükenmez Tigen, E. Nursen Koltka, Arzu Dogru, Melek Gura, Haluk Vahabaoglu

Keywords : Colistin methanesulfonate, nephrotoxicity, risk factors

Citation Information : Tigen ET, Koltka EN, Dogru A, Gura M, Vahabaoglu H. The risk factors of colistin methanesulfonate associated nephrotoxicity. Indian J Crit Care Med 2016; 20 (6):353-356.

DOI: 10.4103/0972-5229.183905

License: CC BY-ND 3.0

Published Online: 01-01-2014

Copyright Statement:  Copyright © 2016; The Author(s).


Purpose: The risk factors of colistin methanesulfonate (CMS) associated nephrotoxicity are important. Our study attempts look into the prevalence of CMS-associated nephrotoxicity in Intensive Care Units (ICUs), and related risk factors. Materials and Methods: The study was conducted between September 2010 and April 2012 on 55 patients who underwent CMS treatment. Nephrotoxicity risk was defined based on the Risk Injury Failure Loss End-stage kidney disease criteria. Results: Fifty-five patients included in the study. A total of 22 (40%) patients developed nephrotoxicity. The correlation was detected between nephrotoxicity and patients over 65 with a high Acute Physiologic Assessment and Chronic Health Evaluation (APACHE) II score. APACHE II score was revealed an independent risk factor for nephrotoxicity. Conclusion: Advanced age and a high APACHE II score are significant risk factors in the development of nephrotoxicity at ICUs following CMS use. Patient selection and close monitoring are critical when starting CMS treatment.

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  1. Price DJ, Graham DI. Effects of large doses of colistin sulphomethate sodium on renal function. Br Med J 1970;4:525-7.
  2. Hartzell JD, Neff R, Ake J, Howard R, Olson S, Paolino K, et al. Nephrotoxicity associated with intravenous colistin (colistimethate sodium) treatment at a tertiary care medical center. Clin Infect Dis 2009;48:1724-8.
  3. Rattanaumpawan P, Ungprasert P, Thamlikitkul V. Risk factors for colistin-associated nephrotoxicity. J Infect 2011;62:187-90.
  4. Bellomo R, Ronco C, Kellum JA, Mehta RL, Palevsky P; Acute Dialysis Quality Initiative workgroup. Acute renal failure – Definition, outcome measures, animal models, fluid therapy and information technology needs: The Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group. Crit Care 2004;8:R204-12.
  5. Balkan II, Dogan M, Durdu B, Batirel A, Hakyemez IN, Cetin B, et al. Colistin nephrotoxicity increases with age. Scand J Infect Dis 2014;46:678-85.
  6. Rocco M, Montini L, Alessandri E, Venditti M, Laderchi A, De Pascale G, et al. Risk factors for acute kidney injury in critically ill patients receiving high intravenous doses of colistin methanesulfonate and/or other nephrotoxic antibiotics: A retrospective cohort study. Crit Care 2013;17:R174.
  7. Sorlí L, Luque S, Grau S, Berenguer N, Segura C, Montero MM, et al. Trough colistin plasma level is an independent risk factor for nephrotoxicity: A prospective observational cohort study. BMC Infect Dis 2013;13:380.
  8. Deryke CA, Crawford AJ, Uddin N, Wallace MR. Colistin dosing and nephrotoxicity in a large community teaching hospital. Antimicrob Agents Chemother 2010;54:4503-5.
  9. Koch-Weser J, Sidel VW, Federman EB, Kanarek P, Finer DC, Eaton AE. Adverse effects of sodium colistimethate. Manifestations and specific reaction rates during 317 courses of therapy. Ann Intern Med 1970;72:857-68.
  10. Paul M, Bishara J, Levcovich A, Chowers M, Goldberg E, Singer P, et al. Effectiveness and safety of colistin: Prospective comparative cohort study. J Antimicrob Chemother 2010;65:1019-27.
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