Prevalencia de injuria renal aguda en pacientes tratados con colistina
Resumen
Introducción: la colistina es un antibiótico eficaz para tratar infecciones causadas por bacterias Gram negativas multirresistentes pero tiende a producir injuria renal aguda.
Objetivos: determinar la frecuencia de injuria renal aguda en pacientes adultos tratados con colistina e identificar la presencia de afecciones comórbidas asociadas.
Metodología: estudio observacional retrospectivo de pacientes tratados con colistina en el Hospital Nacional, Paraguay, en 2016-2017.
Resultados: se estudiaron 80 pacientes, siendo 64% del sexo masculino. La edad media fue 50±17 años. La prevalencia de injuria renal aguda fue 70%. Según los criterios RIFLE hubo lesión en 45% de los casos, riesgo de lesión en 25% y no riesgo/no lesión en 30%. Las afecciones comórbidas más frecuentes fueron la hipertensión arterial (61%) y diabetes mellitus (31%). El germen aislado con mayor frecuencia fue Acinetobacter baumannii (57%), Pseudomonas aeruginosa (24%) y Klebsiella pneumoniae (19%). Los antibióticos más utilizados en forma combinada con la colistina fueron la vancomicina (46%) y los carbapenémicos (43%).
Conclusiones: la prevalencia de injuria renal aguda fue 70%. Según los criterios RIFLE predominó la lesión. Las afecciones comórbidas más frecuentes fueron la hipertensión arterial y la diabetes mellitus.
Citas
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