Association Between XXXX Dose and Development of Nephrotoxicity.

@entity1 @entity3273 @entity1009 @entity281 @entity1011
OBJECTIVE: To investigate the development of nephrotoxicity associated with @entity3273 dose, and whether this relationship differs depending on renal function. DESIGN: A retrospective cohort study of @entity1 who received intravenous @entity3273 to treat @entity281 caused by extensively drug-resistant Gram-negative microorganisms. Adult @entity1 receiving @entity3273 for 72 hours or longer were included in this study. @entity1 who received renal replacement therapy at baseline or were administered @entity3273 for less than 3 days were excluded. @entity3273 -induced nephrotoxicity was defined as a doubling of baseline serum @entity1011 . @entity3273 dosing was evaluated based on both actual body weight and ideal body weight. SETTING: Single general hospital between 2010 and 2013. @entity1 : A total number of 475 @entity1 received @entity3273 therapy. Of these @entity1 , 329 met the inclusion criteria and were included in the analysis. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: One hundred forty-three @entity1 (43.5%) experienced nephrotoxicity during @entity3273 treatment. The median onset time of nephrotoxicity was 6 days (interquartile range, 4-8 days). The @entity1 with nephrotoxicity were older. Hematocrit and serum albumin levels were lower in @entity1 with nephrotoxicity. Median daily dosing of @entity3273 based on ideal body weight was significantly higher in @entity1 with nephrotoxicity than in those without nephrotoxicity (4.55 vs 4.43 mg/kg/d, respectively; p = 0.021). The cumulative dose was not different between @entity1 with and without nephrotoxicity. In multiple logistic regression analysis, daily @entity3273 dosing based on ideal body weight was only significantly associated with the development of nephrotoxicity in @entity1 with an estimated glomerular filtration rate < 60 mL/ @entity1009 .73 m (odds ratio, 2.34; 95% CI, 1.22-4.5). In these affected @entity1 , based on a receiver operating characteristic plot, the optimal predictive cutoff of @entity3273 dose for the development of nephrotoxicity was 2.87 mg/kg/d of @entity3273 , with a sensitivity of 92.3% and a specificity of 76.7%. In @entity1 with estimated glomerular filtration rate >=  60 mL/ @entity1009 .73 m, age, serum albumin, hematocrit, and use of glycopeptide were associated with the development of nephrotoxicity. CONCLUSIONS: Development of nephrotoxicity was significantly more strongly associated with the dose of @entity3273 , but only in @entity1 with an estimated glomerular filtration rate < 60 mL/ @entity1009 .73 m and not in those with normal renal function.
