Impact of total body weight on acute kidney injury in patients with gram-negative bacteremia. Issue 6 (3rd June 2018)

• Record Type: Journal Article
• Authors: Hall, Ronald G.; Yoo, Eunice; Faust, Andrew; Smith, Terri; Goodman, Edward; Mortensen, Eric M.; Felder, Victoria; Alvarez, Carlos A.
• Is Part Of: Expert review of clinical pharmacology. Volume 11:Issue 6(2018)
• Page Start: 651
• Page End: 654
• Publication Date: 2018-06-03
• Subjects: Acute kidney injury -- gram-negative -- total body weight -- bacteremia -- Escherichia coli -- Klebsiella sp; Clinical pharmacology -- Periodicals; 615.105
• DOI: 10.1080/17512433.2018.1471984
• Languages: English
• ISSNs: 1751-2433

Abstract

ABSTRACT: Background : The impact of total body weight (TBW) on the development of acute kidney injury (AKI) associated with gram-negative bacteremia has not been previously evaluated. Methods : The cohort included 323 patients >/ = 18 years old with gram-negative bacteremia (1/1/2008–8/31/2011) who received >/ = 48 hours of antibiotics. We compared the incidence of AKI in patients with a TBW </ = 80kg vs. >80kg with a multivariable stepwise logistic regression adjusting for age >/ = 70 years, baseline serum creatinine of > 2.0 mg/dl, and receipt of a vasopressor. AKI was defined as an increase of 0.5 mg/dL or a > 50% increase from baseline for at least two consecutive days. Results : The cohort was 62% TBW </ = 80kg and 38% TBW >80kg. TBW >80kg patients had higher risk of AKI (24% vs. 9%, p < 0.001), which was significant in the multivariable analysis (OR 3.41, 95% CI 1.73–6.73). A baseline serum creatinine of > 2.0 mg/dl and vasopressor use were also independently associated with AKI. Conclusions : TBW >80kg was associated with the development of AKI. However, the mechanism for this association is not clear.