Dataset Information

Predicting the risk of nephrotoxicity in patients receiving colistimethate sodium: a multicentre, retrospective, cohort study.

ABSTRACT:

Objectives

With increasing rates of infections caused by MDR Gram-negative organisms, clinicians resort to older agents such as colistimethate sodium (CMS) despite a significant risk of nephrotoxicity. Several risk factors for CMS-associated nephrotoxicity have been reported, but they have yet to be validated. We compared the performance of published mathematical models in predicting the risk of CMS-associated nephrotoxicity.

Methods

In a multicentre, retrospective, cohort study, adult patients (?18 years of age) were evaluated from five large academic medical centres in the USA. Patients with normal renal function (baseline serum creatinine ?1.5 mg/dL) who received intravenous CMS for ?72 h were followed for up to 30 days. The development of nephrotoxicity was as defined by the RIFLE criteria. Each published model was conditioned using patient-specific variables to predict the risk of nephrotoxicity. The predictive performance of the models was evaluated using the observed-to-expected (O/E) ratio. The most significant cut-off threshold for stratifying patients into high and low risk of nephrotoxicity was identified using classification and regression tree analysis.

Results

A total of 106 patients were examined (mean age 53.3?±?14.9 years, 66% male); the overall observed nephrotoxicity rate was 52.8%. We identified a simple model demonstrating reasonable overall nephrotoxicity risk assessment [O/E ratio of 1.07 (95% CI?=?0.81-1.39)] and high sensitivity (92.9%) in predicting nephrotoxicity development in patients on CMS therapy.

Conclusions

We identified a model that could be incorporated into patient management strategies to reduce the risk of nephrotoxicity in patients requiring CMS therapy.

SUBMITTER: Phe K

PROVIDER: S-EPMC6296320 | biostudies-literature | 2016 Dec

REPOSITORIES: biostudies-literature

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Publications

Predicting the risk of nephrotoxicity in patients receiving colistimethate sodium: a multicentre, retrospective, cohort study.

Phe Kady K Shields Ryan K RK Tverdek Frank P FP Aitken Samuel L SL Guervil David J DJ Lam Wai-Ying M WM Musgrove Rachel J RJ Luce Andrea M AM Tam Vincent H VH

The Journal of antimicrobial chemotherapy 20160819 12

<h4>Objectives</h4>With increasing rates of infections caused by MDR Gram-negative organisms, clinicians resort to older agents such as colistimethate sodium (CMS) despite a significant risk of nephrotoxicity. Several risk factors for CMS-associated nephrotoxicity have been reported, but they have yet to be validated. We compared the performance of published mathematical models in predicting the risk of CMS-associated nephrotoxicity.<h4>Methods</h4>In a multicentre, retrospective, cohort study, ...[more]

PMID: 27543655

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Dataset Information

Predicting the risk of nephrotoxicity in patients receiving colistimethate sodium: a multicentre, retrospective, cohort study.

Objectives

Methods

Results

Conclusions

Publications

Predicting the risk of nephrotoxicity in patients receiving colistimethate sodium: a multicentre, retrospective, cohort study.

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