ArticleDaru : journal of Faculty of Pharmacy, Tehran University of Medical Sciences2022
Colistin induced acute kidney injury in critically ill children: a prospective study utilizing RIFLE criteria.
Article in Daru : journal of Faculty of Pharmacy, Tehran University of Medical Sciences, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 2 of them syntheses that pooled it.
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3 citing papers in PubMed, 2 syntheses or guidelines pooled it, 3 citations in OpenAlex.
- Clinical outcomes and adverse events associated with intravenous polymyxin-containing therapy in hospitalized children with resistant Gram-negative infections: a systematic review and meta-analysis.Frontiers in pediatrics · 2026Pooled it
- Incidence and risk factors of drug-induced kidney injury in children: a systematic review and meta-analysis.European journal of clinical pharmacology · 2023Pooled it
- Incidence of Antimicrobial-Associated Acute Kidney Injury in Children: A Structured Review.Paediatric drugs · 2024Review
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Authors and funding
8 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundColistin is one of the last resort antibiotic options for resistant gram-negative pathogens. Renal injury is the most common side effect of colistin. Characteristics of nephrotoxicity are well described in adults. However, this data is sparse in children.
objectivesIn this study we evaluated the incidence, severity, time course and risk factors of colistin nephrotoxicity in a pediatric population.
methodsIn a prospective study over a 9-month period, children who received intravenous colistin for at least 48 h were evaluated for renal side effect by utilizing Risk-Injury-Failure-Loss-End Stage Kidney Disease (RIFLE) criteria. Children receiving renal replacement therapy (RRT) or received a repeated course of colistin were excluded.
resultsThirty-seven children were included. Median age of participants was 4.5 months. Overall, 48.6% of the cases developed AKI and consisted 56% in the Risk, 33% in the Injury and 11% in the Failure categories of RIFLE criteria. AKI was reversible while colistin continued and no one required RRT. Mean ± SD time to AKI development was 10.94 ± 7.51 days. Multivariate logistic regression analysis demonstrated that total cumulative dose of colistin was an independent predictor of nephrotoxicity (standardized ß = 1.024, P = 0.034).
conclusionAKI is a common side effect of colistin therapy in critically ill children developing in nearly half of recipients. However, with the dosage range utilized in this study, in the majority of children, renal injury seemed to be mild to moderate in nature. Given the limited treatment options available in critically ill children with resistant gram-negative pathogens, colistin remains a marvelous therapeutic option. Further studies are required to fully elucidate the risk factors and clinical pictures of colistin-induced nephrotoxicity.
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