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Polymyxin-B and vancomycin-associated acute kidney injury in critically ill patients.
Soares, Douglas de Sousa; Reis, André da Fonte; Silva Junior, Geraldo Bezerra da; Leite, Tacyano Tavares; Parente Filho, Sérgio Luiz Arruda; Rocha, Carina Vieira de Oliveira; Daher, Elizabeth De Francesco.
Afiliação
  • Soares DS; a Department of Internal Medicine, School of Medicine, Post-Graduation Program in Medical Sciences , Federal University of Ceará , Fortaleza , Brazil.
  • Reis ADF; b Division of Nephrology , Fortaleza General Hospital , Fortaleza , Brazil.
  • Silva Junior GBD; c School of Medicine, Post-Graduation Program in Collective Health, Health Sciences Center , University of Fortaleza , Fortaleza , Brazil.
  • Leite TT; a Department of Internal Medicine, School of Medicine, Post-Graduation Program in Medical Sciences , Federal University of Ceará , Fortaleza , Brazil.
  • Parente Filho SLA; a Department of Internal Medicine, School of Medicine, Post-Graduation Program in Medical Sciences , Federal University of Ceará , Fortaleza , Brazil.
  • Rocha CVO; a Department of Internal Medicine, School of Medicine, Post-Graduation Program in Medical Sciences , Federal University of Ceará , Fortaleza , Brazil.
  • Daher EF; a Department of Internal Medicine, School of Medicine, Post-Graduation Program in Medical Sciences , Federal University of Ceará , Fortaleza , Brazil.
Pathog Glob Health ; 111(3): 137-142, 2017 May.
Article em En | MEDLINE | ID: mdl-28353411
BACKGROUND: This study aims to investigate renal toxicities of Polymyxin B and Vancomycin among critically ill patients and risk factors for acute kidney injury (AKI). METHODS: This is a cross-sectional study conducted with patients admitted to an intensive care unit (ICU) of a tertiary hospital in Brazil. Patients were divided into two groups: those who used association of Polymyxin B + Vancomycin (Group I) and those who used only Polymyxin B (Group II). Risk factors for AKI were also analyzed. RESULTS: A total of 115 patients were included. Mean age was 59.2 ± 16.1 years, and 52.2% were males. Group I presented higher GFR (117.1 ± 70.5 vs. 91.5 ± 50 ml/min/1.73 m², p = 0.02) as well as lower creatinine (0.9 ± 0.82 vs. 1.0 ± 0.59 mg/dL, p = 0.014) and urea (51.8 ± 23.7 vs. 94.5 ± 4.9 mg/dL, p = 0.006) than group II on admission. Group I also manifested significantly higher incidence of AKI than group II (62.7% vs. 28.5%, p = 0.005), even when stratified according to RIFLE criteria ('Risk' 33.9% vs. 10.7%; 'Injury' 10.2% vs. 8.9%; 'Failure' 18.6% vs. 8.9%; p = 0.03). Accumulated Polymyxin B dose > 10 million IU was an independent predictor for AKI (OR = 2.72, 95% CI = 1.13-6.51, p = 0.024). CONCLUSIONS: Although patients who received Polymyxin B plus vancomycin had more favorable clinical profile and higher previous GFR, they presented a higher AKI incidence than those patients who received Polymyxin B alone. Cumulative Polymyxin B dose > 10 million IU was independently associated to AKI.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Polimixina B / Vancomicina / Injúria Renal Aguda / Antibacterianos Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Aged / Female / Humans / Male / Middle aged País/Região como assunto: America do sul / Brasil Idioma: En Revista: Pathog Glob Health Ano de publicação: 2017 Tipo de documento: Article País de afiliação: Brasil País de publicação: Reino Unido
Texto completo
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Polimixina B / Vancomicina / Injúria Renal Aguda / Antibacterianos Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Aged / Female / Humans / Male / Middle aged País/Região como assunto: America do sul / Brasil Idioma: En Revista: Pathog Glob Health Ano de publicação: 2017 Tipo de documento: Article País de afiliação: Brasil País de publicação: Reino Unido