Risk factors for acute kidney injury in critically ill patients receiving high intravenous doses of colistin methanesulfonate and/or other nephrotoxic antibiotics: a retrospective cohort study

Table 4 Logistic regression analysis of factor associated with AKI in the study cohort

	Univariate analysis			Multivariate analysis
Variables	O.R.	95% C.I.	P -value	O.R.	95% C.I.	P -value
Age, years	1.02	1.01 to 1.04	<0.01
SAPS II score	1.04	1.03 to 1.06	<0.01	1.03	1.01 to 1.05	<0.01
Female	0.63	0.37 to 1.06	0.08	0.62	0.34 to 1.14	0.12
Septic shock at infection onset	7.5	4.36 to 12.9	<0.01	5.89	3.35 to 10.35	<0.01
Albumin serum levels <2 g/dL	2.66	1.32 to 5.37	<0.01
Total bilirubin serum levels >5 mg/dL	2.2	0.85 to 5.65	0.1
NSAID	0.62	0.35 to 1.1	0.1
ACEI	1.83	0.89 to 3.78	0.1
i.v. iodate contrast	1.27	0.76 to 2.1	0.35
Immunocompromised status	1.14	0.63 to 2.05	0.64
Causes of ICU admission
Sepsis	1.9	1.17 to 3.1	<0.01	1.74	0.99 - 3.05	0.052
Neurological disease	0.47	0.18 to 1.24	0.13
Trauma	0.4	0.22 to 0.7	<0.01
Cardiovascular disease	1.61	0.89 to 2.9	0.12
Co-morbidities
Hypertension	1.68	0.92 to 3.05	0.09
Diabetes mellitus	1.79	0.58 to 5.47	0.31
Congestive heart failure	1	0.35 to 2.92	0.99
Two or more comorbidities	2.06	0.9 to 4.72	0.08
Type of infection
VAP	1.19	0.7 to 2.05	0.51
CVC related-BSI	0.86	0.48 to 1.55	0.62
Other	0.81	0.29 to 2.27	0.7
Treatment with CMS (vs. NAs)	0.91	0.56 to 1.47	0.7

The variables included in the final predictive model were selected with a stepwise procedure: albumin serum levels <2 g/dL, total bilirubin serum levels >5 mg/dL, ACE inhibitors, NSAID, age, neurological disease, trauma, cardiovascular disease, hypertension and two or more co-morbidities were variables not included in the final model. We assessed discrimination of the model with area under the receiver operating curve (AUC ± SE = 0.79 ± 0.03 with 95% C.I. 0.74 to 0.84; Chi Square statistics: P <0.001).
ACEI, angiotensin converter enzyme inhibitor; AUC, area under the curve; BSI, bloodstream infection; CI, confidence interval; CMS, colistin methanesulfate; CVC, central venous catheter; NAs, other nephrotoxic antibiotics (aminoglycosides, glycopeptides); NSAID, nonsteroidal anti-inflammatory drug; SAPS II, Simplified Acute Physiology Score Two (calculated 24 h after ICU admission); VAP, ventilator-associated pneumonia.

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