Relationship between plasma polymyxin B concentrations and acute kidney injury in critically ill elderly patients: Findings from a prospective study.

IF 1.4 4区医学 Q4 MEDICINE, RESEARCH & EXPERIMENTAL

Journal of International Medical Research Pub Date : 2025-02-01 DOI:10.1177/03000605251320733

Changyun Zhao, Wenchao Mao, Feifei Ye, Kailun Cai, Shijin Gong, Cong Ye, Yihua Yu

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Abstract

Objective: The objective of this study was to determine the relationship between the plasma polymyxin B concentration and renal function in elderly patients.

Methods: This prospective, case-control, observational study included elderly patients who received polymyxin B therapy and were divided into an acute kidney injury (AKI) group and a non-AKI group based on their renal function. We monitored the pharmacokinetics and pharmacodynamics of polymyxin B, including the minimum plasma concentration (C_min), mean blood drug concentration at steady state (C_ss,avg), and area under the concentration-time curve across 24 h at steady state (AUC_ss,24h) in both study groups. The plasma polymyxin concentration was determined using high-performance liquid chromatography-tandem mass spectrometry.

Results: The loading doses, C_min, C_ss,avg, and AUC_ss,24h were significantly higher in the AKI group than in the non-AKI group (p < 0.05). Receiver-operating characteristic curve analysis showed that the optimal cutoff values for predicting AKI were 2.94 mg/L for C_min, 4.14 mg/L for C_ss,avg, and 99.35 mg·h/L for AUC_ss,24h, with corresponding sensitivities and specificities ranging from 78.57% to 82.14%.

Conclusion: Monitoring plasma polymyxin B concentrations is essential in elderly patients. Keeping the C_min below 2.94 mg/L, the C_ss,avg below 4.14 mg/L, and the AUC_ss,24h below 99.35 mg h/L may help prevent AKI in this population.

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危重老年患者血浆多粘菌素B浓度与急性肾损伤的关系：一项前瞻性研究的结果

目的：探讨老年患者血浆多粘菌素B浓度与肾功能的关系。方法：这项前瞻性、病例对照、观察性研究纳入了接受多粘菌素B治疗的老年患者，根据肾功能分为急性肾损伤（AKI）组和非AKI组。我们监测了多粘菌素B的药代动力学和药效学，包括两个研究组的最低血浆浓度（Cmin）、稳态平均血药浓度（Css,avg）和稳态24h浓度-时间曲线下面积（AUCss,24h）。采用高效液相色谱-串联质谱法测定血浆多粘菌素浓度。结果：AKI组24h的负荷剂量Cmin、Css、avg、AUCss均显著高于非AKI组（p min， Css、avg为4.14 mg/L， AUCss为99.35 mg·h/L），敏感性和特异性范围为78.57% ~ 82.14%。结论：监测老年患者血浆多粘菌素B浓度是必要的。将Cmin控制在2.94 mg/L以下，Css控制在4.14 mg/L以下，auss控制在99.35 mg h/L以下有助于预防该人群的AKI。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of International Medical Research 医学-药学

CiteScore

3.20

自引率

0.00%

发文量

555

审稿时长

1 months

期刊介绍： _Journal of International Medical Research_ is a leading international journal for rapid publication of original medical, pre-clinical and clinical research, reviews, preliminary and pilot studies on a page charge basis. As a service to authors, every article accepted by peer review will be given a full technical edit to make papers as accessible and readable to the international medical community as rapidly as possible. Once the technical edit queries have been answered to the satisfaction of the journal, the paper will be published and made available freely to everyone under a creative commons licence. Symposium proceedings, summaries of presentations or collections of medical, pre-clinical or clinical data on a specific topic are welcome for publication as supplements. Print ISSN: 0300-0605