Amikacin-induced acute kidney injury in mechanically ventilated critically ill patients with sepsis

• DOI: 10.1080/1120009x.2022.2153316
• Publication Date: 2022-12-06T00:18:51Z
• Authors: Bişar Ergün; Fethiye Esenkaya; Murat Küçük; Mehmet Nuri Yakar; Özcan Uzun; Cihan Heybeli; Volkan Hanci; Begüm Ergan; Bilgin Cömert; Ali Necati Gökmen
• Keywords: 0303 health sciences; Colistin; Critical Illness; Acute Kidney Injury; Shock, Septic; Respiration, Artificial; 3. Good health; Intensive Care Units; 03 medical and health sciences; Risk Factors; Sepsis; Humans; Amikacin; Retrospective Studies

In this retrospective cohort study, we aimed to evaluate the incidence, risk factors and outcomes of amikacin-induced acute kidney injury (AKI) in critically ill patients with sepsis. A total of 311 patients were included in the study. Of them, 83 (26.7%) had amikacin-induced AKI. In model 1, the multivariable analysis demonstrated concurrent use of colistin (OR 25.51, 95%CI 6.99-93.05, p< 0.001), presence of septic shock during amikacin treatment (OR 4.22, 95%CI 1.76-10.11, p=0.001), and Charlson Comorbidity Index (OR 1.14, 95%CI 1.02-1.28, p=0.025) as factors independently associated with an increased risk of amikacin-induced AKI. In model 2, the multivariable analysis demonstrated concurrent use of at least one nephrotoxic agent (OR 1.95, 95%CI 1.10-3.45; p=0.022), presence of septic shock during amikacin treatment (OR 3.48, 95%CI 1.61-7.53; p=0.002), and Charlson Comorbidity Index (OR 1.12, 95%CI 1.01-1.26; p=0.037) as factors independently associated with an increased risk of amikacin-induced AKI. In conclusion, before amikacin administration, the risk of AKI should be considered, especially in patients with multiple complicated comorbid diseases, septic shock, and those receiving colistin therapy.