Renal safety of short-term empiric gentamicin therapy in aged patients

Christopher Sb Sia, Michelle R. Ananda-Rajah, Nikki R. Adler, Baey Yi-Wei, Danny Liew, Erica Y. Tong, Ar Kar Aung

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Objective: To determine the incidence of acute kidney injury (AKI) in aged patients receiving empiric gentamicin therapy. Methods: Patients aged ≥65 years receiving gentamicin upon admission between 2013 and 2015 at two Australian hospitals were retrospectively studied. AKI was defined as a rise in creatinine by ≥50% and/or ≥26.5 μmol/L. Results: Most patients (95%) received a single dose of gentamicin. The incidence of AKI was 15% (36/242 patients). A composite outcome of persistent kidney injury, requirement for renal replacement therapy or inpatient death in a patient with AKI occurred in 10 (4%) patients. Patients who developed AKI were older (median 80.5 vs 78 years, P = 0.03), had higher Charlson Co-morbidity Index (median 7 vs 5, P = 0.0004) and had more advanced chronic kidney disease at baseline (Stages IV and V) (OR 4.38, 95% confidence interval 1.45-13.2, P = 0.01). Conclusion: Empiric gentamicin use in patients with advancing age is associated with low rates of predominantly transient renal impairment.

Original languageEnglish
Pages (from-to)227-231
Number of pages5
JournalAustralasian Journal on Ageing
Volume37
Issue number3
DOIs
Publication statusPublished - Sep 2018

Keywords

  • Acute kidney injury
  • Aminoglycosides
  • Gentamicin
  • Nephrology

Cite this

@article{b073498e09f84926bd84a156fdbfe6c1,
title = "Renal safety of short-term empiric gentamicin therapy in aged patients",
abstract = "Objective: To determine the incidence of acute kidney injury (AKI) in aged patients receiving empiric gentamicin therapy. Methods: Patients aged ≥65 years receiving gentamicin upon admission between 2013 and 2015 at two Australian hospitals were retrospectively studied. AKI was defined as a rise in creatinine by ≥50{\%} and/or ≥26.5 μmol/L. Results: Most patients (95{\%}) received a single dose of gentamicin. The incidence of AKI was 15{\%} (36/242 patients). A composite outcome of persistent kidney injury, requirement for renal replacement therapy or inpatient death in a patient with AKI occurred in 10 (4{\%}) patients. Patients who developed AKI were older (median 80.5 vs 78 years, P = 0.03), had higher Charlson Co-morbidity Index (median 7 vs 5, P = 0.0004) and had more advanced chronic kidney disease at baseline (Stages IV and V) (OR 4.38, 95{\%} confidence interval 1.45-13.2, P = 0.01). Conclusion: Empiric gentamicin use in patients with advancing age is associated with low rates of predominantly transient renal impairment.",
keywords = "Acute kidney injury, Aminoglycosides, Gentamicin, Nephrology",
author = "Sia, {Christopher Sb} and Ananda-Rajah, {Michelle R.} and Adler, {Nikki R.} and Baey Yi-Wei and Danny Liew and Tong, {Erica Y.} and Aung, {Ar Kar}",
year = "2018",
month = "9",
doi = "10.1111/ajag.12541",
language = "English",
volume = "37",
pages = "227--231",
journal = "Australasian Journal on Ageing",
issn = "1440-6381",
publisher = "Wiley-Blackwell",
number = "3",

}

Renal safety of short-term empiric gentamicin therapy in aged patients. / Sia, Christopher Sb; Ananda-Rajah, Michelle R.; Adler, Nikki R.; Yi-Wei, Baey; Liew, Danny; Tong, Erica Y.; Aung, Ar Kar.

In: Australasian Journal on Ageing, Vol. 37, No. 3, 09.2018, p. 227-231.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Renal safety of short-term empiric gentamicin therapy in aged patients

AU - Sia, Christopher Sb

AU - Ananda-Rajah, Michelle R.

AU - Adler, Nikki R.

AU - Yi-Wei, Baey

AU - Liew, Danny

AU - Tong, Erica Y.

AU - Aung, Ar Kar

PY - 2018/9

Y1 - 2018/9

N2 - Objective: To determine the incidence of acute kidney injury (AKI) in aged patients receiving empiric gentamicin therapy. Methods: Patients aged ≥65 years receiving gentamicin upon admission between 2013 and 2015 at two Australian hospitals were retrospectively studied. AKI was defined as a rise in creatinine by ≥50% and/or ≥26.5 μmol/L. Results: Most patients (95%) received a single dose of gentamicin. The incidence of AKI was 15% (36/242 patients). A composite outcome of persistent kidney injury, requirement for renal replacement therapy or inpatient death in a patient with AKI occurred in 10 (4%) patients. Patients who developed AKI were older (median 80.5 vs 78 years, P = 0.03), had higher Charlson Co-morbidity Index (median 7 vs 5, P = 0.0004) and had more advanced chronic kidney disease at baseline (Stages IV and V) (OR 4.38, 95% confidence interval 1.45-13.2, P = 0.01). Conclusion: Empiric gentamicin use in patients with advancing age is associated with low rates of predominantly transient renal impairment.

AB - Objective: To determine the incidence of acute kidney injury (AKI) in aged patients receiving empiric gentamicin therapy. Methods: Patients aged ≥65 years receiving gentamicin upon admission between 2013 and 2015 at two Australian hospitals were retrospectively studied. AKI was defined as a rise in creatinine by ≥50% and/or ≥26.5 μmol/L. Results: Most patients (95%) received a single dose of gentamicin. The incidence of AKI was 15% (36/242 patients). A composite outcome of persistent kidney injury, requirement for renal replacement therapy or inpatient death in a patient with AKI occurred in 10 (4%) patients. Patients who developed AKI were older (median 80.5 vs 78 years, P = 0.03), had higher Charlson Co-morbidity Index (median 7 vs 5, P = 0.0004) and had more advanced chronic kidney disease at baseline (Stages IV and V) (OR 4.38, 95% confidence interval 1.45-13.2, P = 0.01). Conclusion: Empiric gentamicin use in patients with advancing age is associated with low rates of predominantly transient renal impairment.

KW - Acute kidney injury

KW - Aminoglycosides

KW - Gentamicin

KW - Nephrology

UR - http://www.scopus.com/inward/record.url?scp=85046009789&partnerID=8YFLogxK

U2 - 10.1111/ajag.12541

DO - 10.1111/ajag.12541

M3 - Article

VL - 37

SP - 227

EP - 231

JO - Australasian Journal on Ageing

JF - Australasian Journal on Ageing

SN - 1440-6381

IS - 3

ER -