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Prevalence of polymyxin-induced nephrotoxicity and its predictors in critically ill adult patients:A meta-analysis

World Journal of Clinical Cases 2022年第31期10卷 11466-11485页

作者： Jiang-Lin Wang Bi-Xiao Xiang Xiao-Li Song Rui-Man Que Xiao-Cong Zuo Yue-Liang Xie Department of Pharmacy The Third Xiangya Hospital of Central South UniversityChangsha 410013Hunan ProvinceChina Department of Pharmacy Sanya Central HospitalSanya 572000Hainan ProvinceChina

BACKGROUND Polymyxin-induced nephrotoxicity is a major safety concern in clinical practice due to long-term adverse outcomes and high *** To conducted a systematic review and meta-analysis of the prevalence and potential predictors of polymyxin-induced nephrotoxicity in adult intensive care unit(ICU)*** PubMed,EMBASE,the Cochrane Library and Reference Citation Analysis database were searched for relevant studies from inception through May 30,*** pooled prevalence of polymyxin-induced nephrotoxicity and pooled risk ratios of associated factors were analysed using a random-effects or fixed-effects model by Stata SE ***,subgroup analyses and meta-regression were conducted to assess *** A total of 89 studies involving 12234 critically ill adult patients were included in the *** overall pooled incidence of polymyxin-induced nephrotoxicity was 34.8%.The pooled prevalence of colistin-induced nephrotoxicity was not higher than that of polymyxin B(PMB)-induced *** subgroup analyses showed that nephrotoxicity was significantly associated with dosing interval,nephrotoxicity criteria,age,publication year,study quality and sample size,which were confirmed in the univariable meta-regression *** was significantly increased when the total daily dose was divided into 2 doses but not 3 or 4 ***,older age,the presence of sepsis or septic shock,hypoalbuminemia,and concomitant vancomycin or vasopressor use were independent risk factors for polymyxin-induced nephrotoxicity,while an elevated baseline glomerular filtration rate was a protective factor against colistin-induced *** Our findings indicated that the incidence of polymyxin-induced nephrotoxicity among ICU patients was *** emphasizes the importance of additional efforts to manage ICU patients receiving polymyxins to decrease the risk of adverse outcomes.

关键词： Polymyxins Nephrotoxicity critically ill adult patients Risk factors Meta-analysis

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