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Kidney Week

Abstract: FR-PO542

Colistin-Induced Acute Tubular Dysfunction: Toxicity Beyond Creatinine

Session Information

Category: Fluid, Electrolytes, and Acid-Base Disorders

  • 1101 Fluid, Electrolyte, and Acid-Base Disorders: Basic

Authors

  • Yama Estrella, Martin Benjamin, Centro Medico Nacional 20 de Noviembre, Mexico City, Mexico City, Mexico
  • Alamilla-Sanchez, Mario, Centro Medico Nacional 20 de Noviembre, Mexico City, Mexico City, Mexico
  • Cano Cervantes, Jose H., Centro Medico Nacional 20 de Noviembre, Mexico City, Mexico City, Mexico
  • Matias Carmona, Mayra May, Centro Medico Nacional 20 de Noviembre, Mexico City, Mexico City, Mexico
  • Morales Lopez, Enrique Fleuvier, Centro Medico Nacional 20 de Noviembre, Mexico City, Mexico City, Mexico
  • Torres Cuevas, Jose Luis, Centro Medico Nacional 20 de Noviembre, Mexico City, Mexico City, Mexico
Background

Colistin is a relevant antibiotic for infections by multiresistant microorganisms. However, it is not exempt from serious renal adverse events, e.g.: acute kidney injury (AKI). The present study describes the hydroelectrolytic disorders associated with the prescription of colistin.

Methods

Retrospective cohort design. Data were obtained from January 2021 to December 2022. Patients who received colistin for at least 48 hours were included. Patients with chronic renal support therapy or acute kidney injury prior to starting colistin were excluded.

Results

23 patients were evaluated, with an average age of 55.96 years, men 60.86%. The most frequently isolated microorganism was P. aeruginosa (56.52%). The reported findings were: euvolemic hyponatremia (39.13%), hypochloremia (43.47%), hypokalemia (52.17%), hypocalcemia (100%), hypophosphatemia (63.63%), and hypomagnesemia (95.23%). 11 patients (47.82%) developed AKI. When comparing the development of electrolyte disturbances between patients with and without AKI, hypomagnesemia was more frequent in the AKI group. There was a constant increase in the renal elimination of potassium, phosphate, and magnesium.

Conclusion

A high incidence of hydroelectrolytic imbalance associated with colistin was found. Interestingly, 100% of patients developed hypocalcemia and the majority had hypomagnesemia and hypophosphatemia. Urinary biochemical evaluation for potassium, phosphate and magnesium provides data highly suggestive of acute tubular dysfunction, an event rarely reported in the literature, which causes high comorbidity if the imbalance is not treated.