Abstract: TH-PO123
Incidence and Risk Factors of AKI in Cancer Patients with Multidrug-Resistant Infections Treated with Colistin
Session Information
- AKI: Biomarkers, Drugs, Onco-Nephrology
November 07, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 102 AKI: Clinical, Outcomes, and Trials
Authors
- Iftikhar, Ayesha, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
- Iqbal, Dr Junaid, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
- Syeda, Umm-e-Rubab, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
- Raza, Aun, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
- Abu bakar, Muhammad, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
- Sultan, Faisal, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
Background
Developing countries have seen a resurgence in the use of Colistin in recent years, for treatment of multidrug resistant (MDR) gram-negative bacterial infections. Colistin is associated with increased risk of nephrotoxicity and consequently poor outcomes in high-risk patients. We studied cancer patients at our centre to determine incidence, risk factors and outcomes of acute kidney injury (AKI) associated with use of Colistin.
Methods
We reviewed patient medical records using electronic information system (eHIS), from January 2015 to December 2018, in this single centre cross-sectional study using secondary data analysis. Adults with solid organ or hematological malignancies with confirmed or suspected multi drug resistant gram-negative infections, who received colistin for at least 48 hours, were included. Outcomes of AKI including need for renal replacement therapy (intermittent or continuous), length of hospital stay and mortality were studied. Patients were followed for 3-6 months following an episode of AKI to review development of chronic kidney disease (CKD). AKI was defined according to Kidney Disease Improving Global Outcomes (KDIGO).
Results
A total of 115 patients were studied. Mean age was 42.6 ± 15.4 years and Mean weight was 60.3 ± 14 kilograms. Majority (68.7%) were male. In multivariable analysis, three independent variables including weight (adjusted odds ratio [AOR] 1.04; 95% confidence interval [CI] 1.01-1.10), underlying malignancy (solid versus hematological (AOR 3.39; 95% CI (1.15-9.98), 0.02) and need for admission to intensive care unit (ICU) (AOR 2.75; 95% CI (1.00-7.82), 0.05) were identified as significant independent risk factors for nephrotoxicity. In patients who had AKI (n=75, 65.2%), mean length of hospital stay was 21.7 ± 13.7 days, 20% required renal replacement therapy (RRT), 10.4% developed residual CKD and 60% died.
Conclusion
Increased weight, solid organ malignancy and ICU admission were significantly associated with increased risk of AKI in this cohort. Patients who required RRT had worse outcomes.