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. 2017 Mar 24;61(4):e02329-16. doi: 10.1128/AAC.02329-16

TABLE 4.

Risk factors for the development of acute kidney injury in non-cystic fibrosis patients treated with polymyxin B or colistin: bivariate and multivariate analysesa

Variable Value(s)
Bivariate analysis
 Multivariate analysis
HR 95% CI P aHR 95% CI P
Polymyxin formulation
    Colistin Reference value Reference value
    Polymyxin B 0.74 0.42–1.31 0.31 1.07 0.56–2.50 0.83
Characteristics of polymyxin therapy
    High doseb 2.11 1.34–3.33 0.001 1.26 0.80–1.97 0.31
    Loading dose 0.67 0.39–1.17 0.16 0.78 0.42–1.46 0.44
    Duration > 10 days 1.38 0.85–2.24 0.20
    Demographics
        Age > 60 yrs 1.30 0.80–2.09 0.29 1.43 0.91–2.52 0.12
        CCI 1.00 0.94–1.07 0.97
        Caucasian 1.38 0.72–2.68 0.33
        Hypertension 0.80 0.50–1.28 0.35
        Diabetes 1.11 0.70–1.74 0.66
Site of care
    Acute Reference value
    ICU 1.11 0.63–1.94 0.72
    PCU 0.56 0.20–1.53 0.26
Concurrent nephrotoxinsc
    Aminoglycosides 1.50 0.94–2.37 0.09 1.22 0.80–1.87 0.35
    Amphotericin B 1.05 0.38–2.90 0.92
    Vancomycin 0.82 0.51–1.30 0.40 0.72 0.45–1.13 0.15
    Calcineurin inhibitors 0.89 0.40–1.95 0.76
    Intravenous contrast 0.27 0.04–1.97 0.20 0.25 0.03–1.86 0.18
    Loop diuretics 2.25 1.39–3.65 <0.001 1.81 1.16–2.83 0.008
    NSAIDS 1.60 0.82–3.12 0.17 1.50 0.78–2.90 0.23
    Vasopressors 1.35 0.84−2.18 0.22
Laboratory abnormalities
    Baseline Scr > 1.5 1.08 0.66–1.74 0.77
    Albumin
        ≥3 g/dl Reference value
        <3 g/dl 0.74 0.43–1.28 0.28
        No albumin level 0.85 0.29–2.54 0.77
    Total bilirubin
        ≤3 mg/dl Reference value
        >3 mg/dl 0.84 0.36–1.96 0.69
        No total bilirubin level 1.10 0.47–2.54 0.83
a

Abbreviations: PMB, polymyxin B; CMS, colistimethate sodium; OR, odds ratio; CI, confidence interval; aOR, adjusted odds ratio; CCI, Charlson comorbidity index; ICU, intensive care unit; PCU, progressive care unit; NSAIDS, nonsteroidal anti-inflammatory drugs; Scr, serum creatinine. The multivariate Cox proportional hazard model included all variables meeting a significance level of a P value of ≤0.20 in bivariate analysis or that were significantly different between the PMB and CMS cohorts at baseline. Data for polymyxin B relative to CMS were forced into the model. Independent predictors of kidney injury are highlighted in bold.

b

High polymyxin doses are defined as PMB doses of ≥200 mg/day and CMS doses of ≥270 mg colistin base activity/day.

c

Concurrent use is defined as administration within 24 h prior to the first polymyxin dose through the end of polymyxin therapy.