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Renal safety of short‐term empiric gentamicin therapy in aged patients
Author(s) -
Sia Christopher SB,
AnandaRajah Michelle R,
Adler Nikki R,
YiWei Baey,
Liew Danny,
Tong Erica Y,
Aung Ar Kar
Publication year - 2018
Publication title -
australasian journal on ageing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.63
H-Index - 34
eISSN - 1741-6612
pISSN - 1440-6381
DOI - 10.1111/ajag.12541
Subject(s) - medicine , gentamicin , acute kidney injury , creatinine , incidence (geometry) , renal function , renal replacement therapy , kidney disease , empiric therapy , confidence interval , surgery , antibiotics , physics , alternative medicine , optics , pathology , microbiology and biotechnology , biology
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.