scholarly journals Prevalence and Risk Factors for Aminoglycoside Nephrotoxicity in Intensive Care Units

2009 ◽  
Vol 53 (7) ◽  
pp. 2887-2891 ◽  
Author(s):  
João F. P. Oliveira ◽  
Carolina A. Silva ◽  
Camila D. Barbieri ◽  
Giselle M. Oliveira ◽  
Dirce M. T. Zanetta ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Odds Ratio ◽  
Kidney Injury ◽  
High Rate ◽  
Iodinated Contrast ◽  
Aminoglycoside Therapy ◽  
Nephrotoxic Drugs ◽  
Independent Risk Factors

ABSTRACT In order to assess the prevalence of and risk factors for aminoglycoside-associated nephrotoxicity in intensive care units (ICUs), we evaluated 360 consecutive patients starting aminoglycoside therapy in an ICU. The patients had a baseline calculated glomerular filtration rate (cGFR) of ≥30 ml/min/1.73 m2. Among these patients, 209 (58%) developed aminoglycoside-associated nephrotoxicity (the acute kidney injury [AKI] group, which consisted of individuals with a decrease in cGFR of >20% from the baseline cGFR), while 151 did not (non-AKI group). Both groups had similar baseline cGFRs. The AKI group developed a lower cGFR nadir (45 ± 27 versus 79 ± 39 ml/min/1.73 m2 for the non-AKI group; P < 0.001); was older (56 ± 18 years versus 52 ± 19 years for the non-AKI group; P = 0.033); had a higher prevalence of diabetes (19.6% versus 9.3% for the non-AKI group; P = 0.007); was more frequently treated with other nephrotoxic drugs (51% versus 38% for the non-AKI group; P = 0.024); used iodinated contrast more frequently (18% versus 8% for the non-AKI group; P = 0.0054); and showed a higher prevalence of hypotension (63% versus 44% for the non-AKI group; P = 0.0003), shock (56% versus 31% for the non-AKI group; P < 0.0001), and jaundice (19% versus 8% for the non-AKI group; P = 0.0036). The mortality rate was 44.5% for the AKI group and 29.1% for the non-AKI group (P = 0.0031). A logistic regression model identified as significant (P < 0.05) the following independent factors that affected aminoglycoside-associated nephrotoxicity: a baseline cGFR of <60 ml/min/1.73 m2 (odds ratio [OR], 0.42), diabetes (OR, 2.13), treatment with other nephrotoxins (OR, 1.61) or iodinated contrast (OR, 2.13), and hypotension (OR, 1.83). In conclusion, AKI was frequent among ICU patients receiving an aminoglycoside, and it was associated with a high rate of mortality. The presence of diabetes or hypotension and the use of other nephrotoxic drugs and iodinated contrast were independent risk factors for the development of aminoglycoside-associated nephrotoxicity.

scholarly journals Risk Factors For Kidney Damage In COVID-19 Patients Admitted To The Intensive Care Unit

2021 ◽  
Vol 10 (2) ◽  
Author(s):  
Diana K. Sarkisian ◽  
Natalia V. Chebotareva ◽  
Valerie McDonnell ◽  
Armen V. Oganesyan ◽  
Tatyana N. Krasnova ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Kidney Injury ◽  
Kidney Damage ◽  
Elderly Age ◽  
Total Blood ◽  
Independent Risk Factors

Background — Acute kidney injury (AKI) reaches 29% in the intensive care unit (ICU). Our study aimed to determine the prevalence, features, and the main AKI factors in critically ill patients with coronavirus disease 2019 (COVID-19). Material and Methods — The study included 37 patients with COVID-19. We analyzed the total blood count test results, biochemical profile panel, coagulation tests, and urine samples. We finally estimated the markers of kidney damage and mortality. Result — All patients in ICU had proteinuria, and 80.5% of patients had hematuria. AKI was observed in 45.9% of patients. Independent risk factors were age more than 60 years, increased C-reactive protein (CRP) level, and decreased platelet count. Conclusion — Kidney damage was observed in most critically ill patients with COVID-19. The independent risk factors for AKI in critically ill patients were elderly age, a cytokine response with a high CRP level.

scholarly journals The Colistin-related nephrotoxicity and risk factors in the intensive care unit; a retrospective study

2021 ◽  
Vol 8 (1) ◽  
pp. 9-13
Author(s):  
Guler Doganay ◽  
Mustafa Ozgur Cirik ◽  
Ali Alagoz
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Significant Risk ◽  
Kidney Injury ◽  
Laboratory Evaluation ◽  
Multi Drug Resistance ◽  
Reactive Protein ◽  
Colistimethate Sodium ◽  
Nephrotoxic Drugs

Objective:  Colistimethate sodium (CMS) which is salvage therapy in the management of infections caused by multi-drug resistance (MDR) gram-negative pathogens is eliminated by the kidneys and cause nephrotoxicity. Many factors may also contribute to this nephrotoxic effect. In this study we aimed to determine the risks for the development of nephrotoxicity patients who received CMS in the intensive care unit (ICU). Materials and Methods: We evaluated retrospectively of the patients who have lung cancer or COPD, aged older than 18 years, and received intravenous CMS therapy at least 72 hours in ICU.  Patients’ age, comorbidities, C-reactive protein (CRP), procalcitonin, albumin, glomerular filtration rate (GFR),  creatinine values on the 1st and 7th days of CMS treatment, positive inotropes,  and nephrotoxic drugs  used concurrently with CMS therapy, and renal replacement therapy (RRT) were recorded. RIFLE score , lenght  of stay (LOS) in hospital and in  the ICU, and 28-day mortality were also recorded. Results: In this study, the GFR and creatinine level deteriorated significantly on the 7th day with CMS therapy patients who had preexisting lower GFR, hypoalbuminemia, and concomitant nephrotoxic drugs usage. The incidence of acute kidney injury was higher in malignant patients and 28-day mortality increased in patients with nephrotoxicity. Conclusion: The CMS therapy with preexisting lower GFR, hypoalbuminemia, and concomitant nephrotoxic drugs usage significant risk factors to develop nephrotoxicity.  It was also higher in malignant patients and increased 28-day mortality. Detailed clinical and laboratory evaluation of the patients is needed before CMS treatment.

scholarly journals Erratum to: Incidence, risk factors and 90-day mortality of patients with acute kidney injury in Finnish intensive care units: the FINNAKI study

2013 ◽  
Vol 39 (4) ◽  
pp. 798-798
Author(s):  
Sara Nisula ◽  
◽  
Kirsi-Maija Kaukonen ◽  
Suvi T. Vaara ◽  
Anna-Maija Korhonen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Kidney Injury ◽  
Incidence Risk

scholarly journals The Risk Factors and Outcome of Acute Kidney Injury in the Intensive Care Units

2010 ◽  
Vol 25 (2) ◽  
pp. 181 ◽  
Author(s):  
Woo Young Park ◽  
Eun Ah Hwang ◽  
Mi Hyun Jang ◽  
Sung Bae Park ◽  
Hyun Chul Kim
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Kidney Injury

scholarly journals Risk factors for the development of hospital infections in the intensive care units

2005 ◽  
Vol 62 (4) ◽  
pp. 265-271 ◽  
Author(s):  
Biljana Mijovic ◽  
Slavenka Jankovic ◽  
Natasa Maksimovic ◽  
Jelena Marinkovic
Keyword(s):  
Risk Factors ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Surveillance Study ◽  
Prospective Surveillance ◽  
Surgical Interventions ◽  
Endotracheal Tubes ◽  
Icu Discharge ◽  
Independent Risk Factors ◽  
Tract Infections

Background. Patients admitted to intensive-care units (ICU) are at a high risk of nosocomial infections (NI) due to susceptibility associated with severity of their condition, but also the invasive medical procedures they undergo. Aim. To determine the frequency of NI at the ICU of the General Hospital Uzice, and to identify the risk factors for their development. Methods. A prospective surveillance study of NI, conducted between June 27 and December 31 2001, included 914 patients who spent at least 24 hours in the ICU (total of 2 615 days). The surveillance of NI in the ICU was carried out daily. Follow-up period covered the time from the ICU admission to 48 hours after the ICU discharge. To assess risk factors for NI, we performed a case-control study. The variables measuring of extrinsic and intrinsic risk factors for NI were collected. Results. In a six-month prospective surveillance study, the incidence of NI was 16.7% or 58.5 per 1,000 patient-day, respectively. The most frequent were the infections of the surgery wounds (32.6%), urinary tract infections (23.5%), and infections of the blood (7.1%). The identified independent risk factors for NI were: surgical intervention (OR = 5.74; CI = 2.01-16.41), endotracheal tubes (OR = 3.40; CI = 1.07-10.89), cystoscopy (OR = 2.35; CI = 1.38- 4.02), obesity (OR = 1.98; CI = 1.27-3.11), and the duration of the infusion (OR = 1.34; CI = 1.23-1.46). Conclusions. The most important risk factors for NI at ICU were surgical interventions and endotracheal tubes.

scholarly journals Mortality risk factors among hospitalized children with severe pertussis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tingting Shi ◽  
Ling Wang ◽  
Shuling Du ◽  
Huifeng Fan ◽  
Minghua Yu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Pulmonary Hypertension ◽  
Intensive Care ◽  
Mortality Risk ◽  
Medical Records ◽  
Odds Ratio ◽  
Hospitalized Children ◽  
Independent Variables ◽  
Independent Risk Factors

Abstract Background Some children hospitalized for severe pertussis need intensive care; moreover, some children die because of deterioration alone or in combination with other complications. The purpose of this study was to identify the mortality risk factors among hospitalized children with severe pertussis. Methods This study evaluated the medical records of 144 hospitalized children with severe pertussis at the Guangzhou Women and Children’s Medical Centre between January 2016 and December 2019. Results The median age of patients was 2 months (IQR 1–4 months), with 90.3% of the patients aged < 6 months and 56.9% of the patients aged < 3 months. A total of 38 patients were admitted to intensive care unit (ICU), 13 patients died, and the mortality of severe pertussis was 34.2%, with patients younger than 6 weeks accounting for 76.9% of the deaths. On the multivariate analysis, the independent risk factors for death were WBC > 70.0 × 109/L (odds ratio [OR], 230.66; 95% confidence interval [CI], 5.16–10,319.09 P = 0.005) and pulmonary hypertension (PH) (OR 323.29; 95% CI 16.01–6529.42; P < 0.001). Conclusion Severe pertussis mainly occurred in children aged < 3 months. The mortality of severe pertussis was 34.2%, with patients younger than 6 weeks accounting for the majority of the deaths. We recommend the first dose of diphtheria-tetanus-pertussis (DTP) should be advanced to the age of 2 months or even 6 weeks. The presence of a WBC > 70.0 × 109/L and PH were the prognostic independent variables associated with death.

Incidence, risk factors and 90-day mortality of patients with acute kidney injury in Finnish intensive care units: the FINNAKI study

2013 ◽  
Vol 39 (3) ◽  
pp. 420-428 ◽  
Author(s):  
Sara Nisula ◽  
◽  
Kirsi-Maija Kaukonen ◽  
Suvi T. Vaara ◽  
Anna-Maija Korhonen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Kidney Injury ◽  
Incidence Risk
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