School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, China.
Eur Rev Med Pharmacol Sci. 2022 May;26(10):3718-3725. doi: 10.26355/eurrev_202205_28868.
Our aim is to investigate the incidence and risk factors of acute kidney injury (AKI) in hospitalized patients who received aminoglycoside antibiotics.
A retrospective analysis was performed on the electronic medical record information of inpatients who received aminoglycoside (AG) antibiotics in our center from January 2018 to December 2020. The diagnosis of AKI was based on serum creatinine changes. Several statistical methods, including chi square test and two sample Wilcoxon rank sum test, were used to evaluate the epidemiological characteristics of aminoglycosides associated AKI. The multivariate logistic regression analysis was used to screen the risk factors.
Finally, 8,040 patients who received AGs were included in the study. Among them, 494 patients (6.14%) were judged as incidence with AKI, while only 29 patients were diagnosed with AKI in the medical record. The multiple logistic regression analysis suggested that admission to ICU, complicated with diabetes mellitus, heart failure, anemia, shock, combined use of diuretics, β-lactam antibiotics, proton pump inhibitors were independent risk factors for AKI related to aminoglycosides.
It is urgent to improve the understanding and attention of AKI for medical workers, and the assessment of risk factors before the use of aminoglycosides should be contributed to the early prevention, diagnosis, and treatment of AKI.
调查接受氨基糖苷类抗生素治疗的住院患者中急性肾损伤(AKI)的发生率和危险因素。
对 2018 年 1 月至 2020 年 12 月期间在我院接受氨基糖苷类(AG)抗生素治疗的住院患者的电子病历信息进行回顾性分析。AKI 的诊断基于血清肌酐变化。采用卡方检验和两样本 Wilcoxon 秩和检验等统计方法评估与氨基糖苷类药物相关 AKI 的流行病学特征。采用多变量逻辑回归分析筛选危险因素。
最终纳入 8040 例接受 AG 治疗的患者。其中 494 例(6.14%)患者被判断为 AKI 发生率,而病历中仅诊断出 29 例 AKI。多变量逻辑回归分析提示,入住 ICU、合并糖尿病、心力衰竭、贫血、休克、联合使用利尿剂、β-内酰胺类抗生素、质子泵抑制剂是与氨基糖苷类药物相关 AKI 的独立危险因素。
医务人员迫切需要提高对 AKI 的认识和重视,在使用氨基糖苷类药物前应评估危险因素,有助于 AKI 的早期预防、诊断和治疗。