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
Changyun Zhao, Wenchao Mao, Feifei Ye, Kailun Cai, Shijin Gong, Cong Ye, Yihua Yu
{"title":"Relationship between plasma polymyxin B concentrations and acute kidney injury in critically ill elderly patients: Findings from a prospective study.","authors":"Changyun Zhao, Wenchao Mao, Feifei Ye, Kailun Cai, Shijin Gong, Cong Ye, Yihua Yu","doi":"10.1177/03000605251320733","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to determine the relationship between the plasma polymyxin B concentration and renal function in elderly patients.</p><p><strong>Methods: </strong>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<sub>min</sub>), mean blood drug concentration at steady state (C<sub>ss,avg</sub>), and area under the concentration-time curve across 24 h at steady state (AUC<sub>ss,24h</sub>) in both study groups. The plasma polymyxin concentration was determined using high-performance liquid chromatography-tandem mass spectrometry.</p><p><strong>Results: </strong>The loading doses, C<sub>min</sub>, C<sub>ss,avg</sub>, and AUC<sub>ss,24h</sub> were significantly higher in the AKI group than in the non-AKI group (<i>p</i> < 0.05). Receiver-operating characteristic curve analysis showed that the optimal cutoff values for predicting AKI were 2.94 mg/L for C<sub>min</sub>, 4.14 mg/L for C<sub>ss,avg</sub>, and 99.35 mg·h/L for AUC<sub>ss,24h</sub>, with corresponding sensitivities and specificities ranging from 78.57% to 82.14%.</p><p><strong>Conclusion: </strong>Monitoring plasma polymyxin B concentrations is essential in elderly patients. Keeping the C<sub>min</sub> below 2.94 mg/L, the C<sub>ss,avg</sub> below 4.14 mg/L, and the AUC<sub>ss,24h</sub> below 99.35 mg h/L may help prevent AKI in this population.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"53 2","pages":"3000605251320733"},"PeriodicalIF":1.4000,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831629/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of International Medical Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/03000605251320733","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"MEDICINE, RESEARCH & EXPERIMENTAL","Score":null,"Total":0}
引用次数: 0

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 (Cmin), mean blood drug concentration at steady state (Css,avg), and area under the concentration-time curve across 24 h at steady state (AUCss,24h) in both study groups. The plasma polymyxin concentration was determined using high-performance liquid chromatography-tandem mass spectrometry.

Results: The loading doses, Cmin, Css,avg, and AUCss,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 Cmin, 4.14 mg/L for Css,avg, and 99.35 mg·h/L for AUCss,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 Cmin below 2.94 mg/L, the Css,avg below 4.14 mg/L, and the AUCss,24h below 99.35 mg h/L may help prevent AKI in this population.

求助全文
约1分钟内获得全文 求助全文
来源期刊
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
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信