Colistimethate 분무요법 시행 환자에서 투여 전후 신기능의 변화
Changes in Renal Function by Nebulized Colistimethate Treatment
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Background: Nebulized colistimethate is increasingly used, because there are problems such as renal dysfunction and lowdistribution within the lungs when colistimethate is administered intravenously. This study was designed to compare and analyzethe changes in renal function by of nebulized colistimethate treatment for its safe administration. Methods: This study retrospectivelyreviewed the electronic medical records of adult patients above 19 years old, receiving only the nebulized colistimethate at least 4days in Yonsei university health system from Nov 2014 to Aug 2015. Acute kidney injury (AKI) was determined by using the RIFLEcriteria (Risk, Injury, Failure, Loss and End-stage renal disease) according to serum creatinine (SCr) levels before and after use ofnebulized colistimethate. Results: 48 patients were included our study and their SCr increased significantly after nebulizedcolistimethate treatment (SCr0 vs. SCr1; 0.85±0.80 vs. 1.00±0.82 mg/dL, n=48, p<0.001), but the changes were in normal rangeaccording to the standards at Yonsei university health systema. Among 48 patients, 38 patients were in the non-AKI group (79.2%),and 10 patients developed AKI (20.8%). Within the AKI group, 2 patients were in the Injury group (20%) and the other 8 in the Riskgroup (80%). Conclusion: There was no significant difference in age, dosage and duration of treatment between AKI group andnon-AKI group (p>0.05). The study has a significance in that it reviewed the safety of nebulized colistimethate only treatment tonational patients, analyzing its nephrotoxicity. It has confirmed that nebulized colistimethate is a safer method than intravenousinjection, and requires to establish a guideline for the use of nebulized colistimethate in further studies with broader patient groups. a: SCr Male 0.68-1.19 mg/dL, Female 0.49-0.91 mg/dL
Abstract
Background: Nebulized colistimethate is increasingly used, because there are problems such as renal dysfunction and lowdistribution within the lungs when colistimethate is administered intravenously. This study was designed to compare and analyzethe changes in renal function by of nebulized colistimethate treatment for its safe administration. Methods: This study retrospectivelyreviewed the electronic medical records of adult patients above 19 years old, receiving only the nebulized colistimethate at least 4days in Yonsei university health system from Nov 2014 to Aug 2015. Acute kidney injury (AKI) was determined by using the RIFLEcriteria (Risk, Injury, Failure, Loss and End-stage renal disease) according to serum creatinine (SCr) levels before and after use ofnebulized colistimethate. Results: 48 patients were included our study and their SCr increased significantly after nebulizedcolistimethate treatment (SCr0 vs. SCr1; 0.85±0.80 vs. 1.00±0.82 mg/dL, n=48, p<0.001), but the changes were in normal rangeaccording to the standards at Yonsei university health systema. Among 48 patients, 38 patients were in the non-AKI group (79.2%),and 10 patients developed AKI (20.8%). Within the AKI group, 2 patients were in the Injury group (20%) and the other 8 in the Riskgroup (80%). Conclusion: There was no significant difference in age, dosage and duration of treatment between AKI group andnon-AKI group (p>0.05). The study has a significance in that it reviewed the safety of nebulized colistimethate only treatment tonational patients, analyzing its nephrotoxicity. It has confirmed that nebulized colistimethate is a safer method than intravenousinjection, and requires to establish a guideline for the use of nebulized colistimethate in further studies with broader patient groups. a: SCr Male 0.68-1.19 mg/dL, Female 0.49-0.91 mg/dL
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