单位：[a]China-Japan Friendship Hospital, National Clinical Research Center for Respiratory Diseases, Clinical Center for Pulmonary Infections, Capital Medical University, Beijing, 100029, China.[b]Peking University Clinical Research Institute, Peking University First Hospital, 38 Xueyuan Rd, Haidian District, Beijing, 100191, China.[c]Department of Respiratory and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Sciences & Technology, Wuhan, 430030, China.华中科技大学同济医学院附属同济医院[d]Department of Intensive Care Unit, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, 310014, China.[e]Department of Respiratory and Critical Care Medicine, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi, 214023, China.[f]Department of Respirology and Critical Care Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China.江苏省人民医院[g]Department of General Intensive Care Unit, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 310052, China.[h]Department of Pulmonary and Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430062, China.[i]Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.[j]Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, 201799, China.[k]Department of Respiratory Medicine, The Second Xiangya Hospital, Central South University, Changsha, 410012, China.[l]Departments of Respiratory Medicine, Fujian Medical University Union Hospital, Fujian Medical University, Fuzhou, 350001, China.[m]Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, China.[n]Department of Respiratory and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.华中科技大学同济医学院附属协和医院[o]Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China.[p]Department of Pulmonary and Critical Care Medicine, China Centre of Respiratory Medicine, National Clinical Research Centre for Respiratory Diseases, China-Japan Friendship Hospital, Institute of Respiratory Medicine, Beijing, 100029, China.[q]Department of Pulmonary and Critical Care Medicine, China Centre of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College, Department of Respiratory Medicine, Capital Medical University, Tsinghua University School of Medicine, Beijing, 100029, China.
Objectives: This study aimed to assess the current incidence and risk factors for polymyxin B-associated acute kidney injury (AKI) in Chinese hospitals for a more effective clinical use for polymyxin B. Methods: This multicenter, retrospective cohort study included patients from 14 Chinese teaching hospitals who received polymyxin B therapy. Univariate and multivariate logistic regression models were used to determine the factors associated with polymyxin B-associated incident AKI. Furthermore, a multivariate logistic regression model was used to identify the independent risk factors for AKI. Results: A total of 251 patients were included in the analysis. The overall incidence of AKI was 33.5%. A multivariate logistic regression model identified the loading dose (hazard ratio (HR), 1.84; 95% confidence interval (CI), 1.01-3.38; P = 0.0491) and the use of two or more nephrotoxic drugs (HR, 3.56; 95% CI, 1.55-8.18; P = 0.0029) as independent risk factors for the occurrence of AKI. Meanwhile, the estimated glomerular filtration rate had a protective effect (HR, 0.99; 95% CI, 0.98-0.99; P = 0.0 0 06) on the occurrence of AKI. The daily dose, cumulative dose, and treatment duration of polymyxin B did not affect the occurrence of AKI.Conclusions: The use of polymyxin B loading doses and the combined use of multiple nephrotoxic drugs are independent risk factors for polymyxin B-associated AKI. The severity of AKI may be higher in patients with elevated baseline creatinine levels.(c) 2022 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
基金：
CAMS Innovation Fund for Medi-cal Sciences [2018-I2M-1-0 03]
第一作者单位：[a]China-Japan Friendship Hospital, National Clinical Research Center for Respiratory Diseases, Clinical Center for Pulmonary Infections, Capital Medical University, Beijing, 100029, China.
通讯作者：
通讯机构：[p]Department of Pulmonary and Critical Care Medicine, China Centre of Respiratory Medicine, National Clinical Research Centre for Respiratory Diseases, China-Japan Friendship Hospital, Institute of Respiratory Medicine, Beijing, 100029, China.[q]Department of Pulmonary and Critical Care Medicine, China Centre of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College, Department of Respiratory Medicine, Capital Medical University, Tsinghua University School of Medicine, Beijing, 100029, China.[*1]Department of Pulmonary and Critical Care Medicine, China Centre of Respiratory Medicine, National Clinical Research Centre for Respiratory Diseases, China-Japan Friendship Hospital, Institute of Respiratory Medicine, No. 2 East Yinghua Road, Chaoyang District, Beijing, 100029, China[*2]Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, No. 2 East Yinghua Road, Chaoyang District, Beijing, 100029, China
推荐引用方式(GB/T 7714)：
Kang Chang,Haibo Wang,Jianping Zhao,et al.Risk factors for polymyxin B-associated acute kidney injury[J].INTERNATIONAL JOURNAL of INFECTIOUS DISEASES.2022,117:37-44.doi:10.1016/j.ijid.2022.01.055.
APA：
Kang Chang,Haibo Wang,Jianping Zhao,Xianghong Yang,Bo Wu...&Bin Cao.(2022).Risk factors for polymyxin B-associated acute kidney injury.INTERNATIONAL JOURNAL of INFECTIOUS DISEASES,117,
MLA：
Kang Chang,et al."Risk factors for polymyxin B-associated acute kidney injury".INTERNATIONAL JOURNAL of INFECTIOUS DISEASES 117.(2022):37-44
