P-17 AMIKACIN USE AND RISK OF NEPHROTOXICITY IN PATIENTS WITH LIVER CIRRHOSIS HOSPITALIZED FOR SEPSIS

Conflict of interest: No Introduction and Objectives: Aminoglycosides are a group of broad-spectrum antibiotics, which have action especially against gram-negative bacteria. It is associated with nephrotoxicity in 10-20% of cases, a figure that increases in patients with liver cirrhosis. Amikacin is...

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Main Authors: Alonso Saez, Carlos Padilla, Daniela Simian, Juan Medel, Gabriel Mendez, María Gómez, Alvaro Urzúa, Juan Pablo Roblero, Jaime Poniachik
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:Annals of Hepatology
Online Access:http://www.sciencedirect.com/science/article/pii/S1665268124004149
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author Alonso Saez
Carlos Padilla
Daniela Simian
Juan Medel
Gabriel Mendez
María Gómez
Alvaro Urzúa
Juan Pablo Roblero
Jaime Poniachik
author_facet Alonso Saez
Carlos Padilla
Daniela Simian
Juan Medel
Gabriel Mendez
María Gómez
Alvaro Urzúa
Juan Pablo Roblero
Jaime Poniachik
author_sort Alonso Saez
collection DOAJ
description Conflict of interest: No Introduction and Objectives: Aminoglycosides are a group of broad-spectrum antibiotics, which have action especially against gram-negative bacteria. It is associated with nephrotoxicity in 10-20% of cases, a figure that increases in patients with liver cirrhosis. Amikacin is frequently used in sepsis, with little information about the risk of nephrotoxicity in cirrhosis. The aim was to determine the association between amikacin use and renal function deterioration in patients with liver cirrhosis and sepsis. Patients / Materials and Methods: Retrospective, observational, analytical study in patients with liver cirrhosis of any etiology, who required hospitalization for sepsis between 2017 and 2023, and who received antibiotic therapy. An increase in serum creatinine ≥ 0.3 mg/dl in the first 7 days of hospitalization was used as a marker of renal function deterioration. Clinical variables, renal failure and mortality were compared between patients who received amikacin and those who did not. Stata 13.0 was used for data analysis with a statistical significance of 0.05. Results and Discussion: In this study 228 patients were included, median age 65 years (54-70), 100 (44%) women, 70 received amikacin (31%). Renal function deterioration was present in 25 (36%) patients with amikacin and 33 (21%) without amikacin. In patients with initial serum creatinine > 2.0 mg/dl and in those with Child-Pugh C cirrhosis, the probability of developing renal function deterioration was higher in those who received Amikacin (OR 7.5; 95% CI 1.1 – 48.0, p= 0.031 and OR 2.51; 95% CI 1.06 – 5.97, p = 0.036, respectively). A comparative table of different subgroups is attached. Conclusions: The use of amikacin was associated with renal function deterioration in patients with liver cirrhosis and sepsis, mainly in Child-Pugh C cirrhosis and with initial serum creatinine > 2.0 mg/dl.
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spelling doaj-art-baaa6513bf264614b91c9a092f5c78512025-08-20T02:20:33ZengElsevierAnnals of Hepatology1665-26812024-12-012910163110.1016/j.aohep.2024.101631P-17 AMIKACIN USE AND RISK OF NEPHROTOXICITY IN PATIENTS WITH LIVER CIRRHOSIS HOSPITALIZED FOR SEPSISAlonso Saez0Carlos Padilla1Daniela Simian2Juan Medel3Gabriel Mendez4María Gómez5Alvaro Urzúa6Juan Pablo Roblero7Jaime Poniachik8Sección de Gastroenterología, Departamento de Medicina Interna, Hospital Clínico Universidad de Chile, Santiago, Chile, Santiago, ChileSección de Gastroenterología, Departamento de Medicina Interna, Hospital Clínico Universidad de Chile, Santiago, Chile, Santiago, ChileSección de Gastroenterología, Departamento de Medicina Interna, Hospital Clínico Universidad de Chile, Santiago, Chile, Santiago, ChileUnidad de Paciente Crítico, Hospital Clínico Universidad de Chile, Santiago, Chile, Santiago, ChileFacultad de Medicina Universidad de Chile, Santiago, Chile, Santiago, ChileFacultad de Medicina Universidad de Chile, Santiago, Chile, Santiago, ChileSección de Gastroenterología, Departamento de Medicina Interna, Hospital Clínico Universidad de Chile, Santiago, Chile, Santiago, ChileSección de Gastroenterología, Departamento de Medicina Interna, Hospital Clínico Universidad de Chile, Santiago, Chile, Santiago, ChileSección de Gastroenterología, Departamento de Medicina Interna, Hospital Clínico Universidad de Chile, Santiago, Chile, Santiago, ChileConflict of interest: No Introduction and Objectives: Aminoglycosides are a group of broad-spectrum antibiotics, which have action especially against gram-negative bacteria. It is associated with nephrotoxicity in 10-20% of cases, a figure that increases in patients with liver cirrhosis. Amikacin is frequently used in sepsis, with little information about the risk of nephrotoxicity in cirrhosis. The aim was to determine the association between amikacin use and renal function deterioration in patients with liver cirrhosis and sepsis. Patients / Materials and Methods: Retrospective, observational, analytical study in patients with liver cirrhosis of any etiology, who required hospitalization for sepsis between 2017 and 2023, and who received antibiotic therapy. An increase in serum creatinine ≥ 0.3 mg/dl in the first 7 days of hospitalization was used as a marker of renal function deterioration. Clinical variables, renal failure and mortality were compared between patients who received amikacin and those who did not. Stata 13.0 was used for data analysis with a statistical significance of 0.05. Results and Discussion: In this study 228 patients were included, median age 65 years (54-70), 100 (44%) women, 70 received amikacin (31%). Renal function deterioration was present in 25 (36%) patients with amikacin and 33 (21%) without amikacin. In patients with initial serum creatinine > 2.0 mg/dl and in those with Child-Pugh C cirrhosis, the probability of developing renal function deterioration was higher in those who received Amikacin (OR 7.5; 95% CI 1.1 – 48.0, p= 0.031 and OR 2.51; 95% CI 1.06 – 5.97, p = 0.036, respectively). A comparative table of different subgroups is attached. Conclusions: The use of amikacin was associated with renal function deterioration in patients with liver cirrhosis and sepsis, mainly in Child-Pugh C cirrhosis and with initial serum creatinine > 2.0 mg/dl.http://www.sciencedirect.com/science/article/pii/S1665268124004149
spellingShingle Alonso Saez
Carlos Padilla
Daniela Simian
Juan Medel
Gabriel Mendez
María Gómez
Alvaro Urzúa
Juan Pablo Roblero
Jaime Poniachik
P-17 AMIKACIN USE AND RISK OF NEPHROTOXICITY IN PATIENTS WITH LIVER CIRRHOSIS HOSPITALIZED FOR SEPSIS
Annals of Hepatology
title P-17 AMIKACIN USE AND RISK OF NEPHROTOXICITY IN PATIENTS WITH LIVER CIRRHOSIS HOSPITALIZED FOR SEPSIS
title_full P-17 AMIKACIN USE AND RISK OF NEPHROTOXICITY IN PATIENTS WITH LIVER CIRRHOSIS HOSPITALIZED FOR SEPSIS
title_fullStr P-17 AMIKACIN USE AND RISK OF NEPHROTOXICITY IN PATIENTS WITH LIVER CIRRHOSIS HOSPITALIZED FOR SEPSIS
title_full_unstemmed P-17 AMIKACIN USE AND RISK OF NEPHROTOXICITY IN PATIENTS WITH LIVER CIRRHOSIS HOSPITALIZED FOR SEPSIS
title_short P-17 AMIKACIN USE AND RISK OF NEPHROTOXICITY IN PATIENTS WITH LIVER CIRRHOSIS HOSPITALIZED FOR SEPSIS
title_sort p 17 amikacin use and risk of nephrotoxicity in patients with liver cirrhosis hospitalized for sepsis
url http://www.sciencedirect.com/science/article/pii/S1665268124004149
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