Double-edged Knife: Can Colistin Nephrotoxicity be Prevented with High Doses of Vitamin C?
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Tarih
2021
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Bilimsel Tip Yayinevi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Introduction: In this study, it was aimed to determine the risk factors for developing acute kidney injury (AKI) and effects of ascorbic acid on the development of nephrotoxicity in patients receiving systemic colistin sodium therapy. Materials and Methods: We retrospectively reviewed records of cases who were treated with systemic colistin sodium and did not have any known renal disease in our hospital between the years of 2014 and 2019. The demographic characteristics, indications for systemic colistin, other antibiotics applied and nephrotoxic drugs, vasopressor necessity, daily creatinine values, development of acute kidney injury, and ascorbic acid use were evaluated. Acute kidney injury was assessed according to KDIGO 2017. Results: Sixty-six patients were included in the study. In addition to colistin therapy, 33 cases who received at least three grams of ascorbic acid per day and 33 cases who received only colistin therapy were evaluated retrospectively. Acute kidney injury developed in 12 (36.4%) of those receiving ascorbic acid and 15 (45.5%) in those not receiving ascorbic acid (p= 0.617). Acute kidney injury developed in 9.1 +/- 5.9 days in ascorbic acid patients and 7.1 +/- 4.4 days in non-ascorbic acid patients (p= 0.314). The rate of septic shock development was significantly lower in patients receiving ascorbic acid (30.3% vs 57.6%, p= 0.046). Advanced age (p= 0.005), sepsis (p= 0.046), and underlying cardiac disease (p= 0.01) were found to be statistically significant in terms of the development of nephrotoxicity. Conclusion: Although no statistically significant effect of ascorbic acid using on the development of colistin-related nephrotoxicity was determined in our study, we think that high dose vitamin C may be beneficial in selected patient groups in terms of the fact that AKI is seen less in the group using ascorbic acid, does not have serious side effects and has a positive effect on preventing from septic shock. However further research is needed with more patients.
Açıklama
Anahtar Kelimeler
Colistin, Ascorbic acid, Nephrotoxicity, Critically-Ill Patients, Ascorbic-Acid, Pharmacokinetics, Methanesulfonate, Care
Kaynak
Flora Infeksiyon Hastaliklari Ve Klinik Mikrobiyoloji Dergisi
WoS Q Değeri
N/A
Scopus Q Değeri
Cilt
26
Sayı
2
