Colistin may be used to treat infections caused by extensively drug-resistant Gram-negative bacteria. Nephrotoxicity is a limiting factor for its use. A number of factors may contribute to nephrotoxicity.

Nephrotoxicity was defined as >= 2 fold increase in the serum creatinine concentration from baseline.


Risk factors for nephrotoxicity include:

(1) older age

(2) hypoalbuminemia

(3) concurrent therapy with glycopeptide or other nephrotoxin

(4) GFR < 60 mL per minute per 1.73 square meter AND high dose of colistin (>= 2.87 mg per day per kilogram of ideal body weight)

(5) anemia

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