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Goenaga Sánchez MÁ, Kortajarena Urkola X, Bouza Santiago E, Muñoz García P, Verde Moreno E, Fariñas Álvarez MC, Teira Cobo R, Pericás Pulido JM, de Alarcón González A, Sousa Regueiro D, Ruiz Morales J, Rodríguez-Álvarez RJ, Antorrena Miranda I, Iribarren Loyarte JA. Aetiology of renal failure in patients with infective endocarditis. The role of antibiotics. Med Clin (Barc) 2017; 149:331-338. [PMID: 28431897 DOI: 10.1016/j.medcli.2017.03.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 02/23/2017] [Accepted: 03/02/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND OBJECTIVES The possible renal toxicity of certain antibiotics (AB) is well known. The objective of our work is to know the possible effect of AB treatments in the development of renal failure (RF) in patients with infective endocarditis (IE). MATERIAL AND METHOD Collection from a national multi-centre registry of collection on renal function, both prior and its impairment, if any, during the treatment of IE and in relation to possible causative factors, including the use of AB. RESULTS Between 2008 and 2012, 1,853 episodes of IE reported from 26 Spanish centres were analysed. Of these, 21.6% had prior RF. They developed new RF or impairment of renal function in 38.7% of the cases. In patients with prior RF, impairment was more frequent (64 vs. 31.7%, P<.001). Overall, patients with RF were older (70.6 vs. 67 years, P<.01), had more comorbidities (Charlson index 5 vs. 4, P<.01), and IE by Staphylococcus aureus (32.1 vs. 16.5%, P<.01). Potentially nephrotoxic AB use was only associated with RF in patients without prior RF (aminoglycosides: OR=1.47 [95% CI 1.096-1.988], P=.010; aminoglycosides with vancomycin: OR=1.49 [95% CI 1.069-2.09], P=.019). CONCLUSIONS In patients without prior RF, the use of nephrotoxic AB is associated with impairment of renal function. In patients with RF prior to the IE episode, impairment of renal function was more frequent but appears to be more related to the severity of infection.
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Affiliation(s)
| | - Xabier Kortajarena Urkola
- Servicio de Enfermedades Infecciosas, Hospital Universitario Donostia, San Sebastián, Guipúzcoa, España
| | - Emilio Bouza Santiago
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES) (CB06/06/0058), Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España
| | - Patricia Muñoz García
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES) (CB06/06/0058), Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España
| | - Eduardo Verde Moreno
- Servicio de Nefrología, Hospital General Universitario Gregorio Marañón, Madrid, España
| | - M Carmen Fariñas Álvarez
- Servicio de Enfermedades Infecciosas, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, Santander, España
| | - Ramón Teira Cobo
- Servicio de Medicina Interna, Hospital Sierrallana, Torrelavega, Santander, España
| | - Juan Manuel Pericás Pulido
- Servicio de Enfermedades Infecciosas, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, España
| | - Arístides de Alarcón González
- Clinical Unit of Infectious Diseases, Microbiology and Preventive Medicine Infectious Diseases Research Group, Institute of Biomedicine of Seville (IBIS), University of Seville/CSIC/University Virgen del Rocío and Virgen Macarena, Sevilla, España
| | - Dolores Sousa Regueiro
- Servicio de Enfermedades Infecciosas, Complejo Hospitalario Universitario de A Coruña, A Coruña, España
| | - Josefa Ruiz Morales
- Unidad de Gestión Clínica de Enfermedades Infecciosas, Hospital Clínico Universitario Virgen de la Victoria, Málaga, España
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