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Polymyxin Acute Kidney Injury: a case of severe tubulopathy

Lucas Alexandre de Mello Goldin1, Leticia Nicoletti Silva1, Thiago Florencio da Silva1

  • 1Hospital Evangélico de Londrina, Departamento de Nefrologia, Londrina, PR, Brasil.

Jornal Brasileiro De Nefrologia
|April 23, 2021
PubMed

Insights

Polymyxin B can cause severe electrolyte imbalances, including hypocalcemia, hypomagnesemia, and hypokalemia. Monitoring these essential mineral levels during polymyxin treatment is crucial for patient safety.

Area of Science:

  • Nephrology
  • Pharmacology
  • Internal Medicine

Background:

  • Polymyxins are antibiotics primarily known for neurotoxicity.
  • Nephrotoxicity and tubulopathy associated with polymyxins are less frequently documented in medical literature.

Observation:

  • A case report details a patient treated with polymyxin B for a surgical wound infection.
  • The patient experienced significant increases in fractional excretion of calcium, magnesium, and potassium.

Findings:

  • This led to persistent, severe decreases in serum calcium, magnesium, and potassium levels.
  • The patient developed hypocalcemia, hypomagnesemia, and hypokalemia.

Implications:

  • Polymyxin therapy can result in life-threatening electrolyte disturbances.
  • Regular monitoring of serum calcium, magnesium, and potassium is essential during polymyxin treatment.

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