Related Experiment Video
Updated: Oct 4, 2025
Murine Renal Transplantation Procedure
Published on: July 10, 2009
Nephrotoxicity and Efficacy Assessment of Polymyxin B Use in Renal Transplant Patients
Yu-Xin Wen1,2, Qiang Qu3,4, Wen-Ming Long5
1Department of Pharmacy, The Second Xiangya Hospital, Central South University; Institute of Clinical Pharmacy, Central South University, Changsha, 410011, People's Republic of China.
Purpose:
This study investigates the nephrotoxicity and efficacy assessment of polymyxin B (PMB) use in renal transplant patients.
Patients And Methods:
This retrospective study included adult (>18 years of age) renal transplant patients who received PMB intravenous drip for more than 72 hours. Efficacy assessment of PMB included clinical treatment efficacy, microbiological efficacy at the end of PMB treatment, and in-hospital all-cause mortality. Nephrotoxicity of PMB was evaluated for further group comparison.
Results:
We enrolled 235 renal transplant patients in our study. After PMB treatment, 45 patients occurred PMB-nephrotoxicity, and the nephrotoxicity rate was 19.15%. Among them, 44 patients were RIFLE R stage, and one patient was RIFLE I stage. The dose of PMB used in patients was 40.0 (40.0-50.0) mg q12h with a loading dose of 41.8±9.8 mg. Multivariate logistic regression analysis showed that ICU admission, vasoactive agents, aminoglycosides, creatinine clearance rate before PMB use, and mean total hospital stay were independent risk factors of PMB-nephrotoxicity in kidney transplant patients. The clinical effective rate was 97.9%, and the microbiological clean rate was 66.7%.
Conclusion:
Our study demonstrated that PMB low dose regimens might achieve good efficacy and less nephrotoxicity in renal transplant patients. We should evaluate the severity of the infection and renal function of patients, avoid the combined use of other nephrotoxic drugs, and minimize the course of use to reduce the occurrence of PMB-nephrotoxicity.
Insights
Polymyxin B (PMB) shows good efficacy in renal transplant patients with a 19.15% nephrotoxicity rate. Lower doses and careful drug combinations may reduce kidney damage.
Area of Science:
- Nephrology
- Pharmacology
- Transplantation
Background:
- Polymyxin B (PMB) is crucial for treating multidrug-resistant infections.
- Assessing PMB's safety and effectiveness in renal transplant recipients is vital due to potential nephrotoxicity.
Purpose of the Study:
- To investigate the nephrotoxicity and efficacy of Polymyxin B (PMB) in adult renal transplant patients.
- To identify risk factors associated with PMB-induced nephrotoxicity in this population.
Main Methods:
- Retrospective study of 235 adult renal transplant patients receiving intravenous PMB for over 72 hours.
- Evaluated clinical and microbiological efficacy, all-cause mortality, and PMB-nephrotoxicity.
- Multivariate logistic regression identified risk factors for nephrotoxicity.
Main Results:
- The PMB-nephrotoxicity rate was 19.15% (45/235 patients), with most cases at RIFLE R stage.
- Independent risk factors for nephrotoxicity included ICU admission, vasoactive agents, aminoglycosides, pre-PMB creatinine clearance, and hospital stay duration.
- Clinical efficacy was 97.9%, and microbiological clearance was 66.7%.
Conclusions:
- Low-dose Polymyxin B regimens can be effective with potentially reduced nephrotoxicity in renal transplant patients.
- Careful patient selection, monitoring renal function, avoiding concurrent nephrotoxic drugs, and limiting treatment duration are recommended to minimize PMB-nephrotoxicity.
Related Concept Videos
01:26Kidney Transplant II: Surgical Procedure
01:16Kidney Transplant III: Nursing Management
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
01:28Kidney Transplant I: Introduction
01:26Pharmacokinetics in Pediatric Patients: Drug Excretion
01:11Renal Failure: Dose Adjustments
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...