Case-control study of acute renal failure in patients with cystic fibrosis in the UK

Smyth, A.; Lewis, S.; Bertenshaw, C.; Choonara, I.; McGaw, J.; Watson, A.
June 2008
Thorax;Jun2008, Vol. 63 Issue 6, p532
Academic Journal
Background: There has been a recent increase in the number of reported cases of acute renal failure (ARE) in cystic fibrosis (CE). A case-control study was conducted to determine the factors which are associated with an increased risk of ARF. Methods: 24 cases of confirmed ARF were identified in patients with CF from 20 UK CF centres presenting between 1997 and 2004. Using the UK CF database, sex- and age-matched controls were identified. Risk factors were analysed by conditional logistic regression and Mantel-Haenszel analysis. Results: 21 of the 24 patients with ARE had received an aminoglycoside at the time of their episode of ARE or in the preceding week compared with only 3 of 42 controls during the same time period (OR 81.8, 95% Cl 4.7 to 1427, p<0.001). In the year before the episode of ARF, significantly more cases than controls had received gentamicin (19/24 cases vs 1/42 controls, p<0.001). The numbers receiving tobramycin were similar (9/24 cases vs 16/42 controls, p = 0.9). A known risk factor for renal impairment (prior renal disease, acute dehydration or long-term treatment with a nephrotoxic drug) was present in 18/24 cases and 7/42 controls (OR 24.0, 95% CI 3.1 to 186.6, p = 0.002). Conclusions: In patients with CF the use of an intravenous aminoglycoside is a risk factor for ARF; gentamicin is more nephrotoxic than tobramycin. Most patients who develop ARF have a risk factor which necessitates withholding aminoglycosides or more closely monitoring their use.


Related Articles

  • Are Elevated Vancomycin Serum Trough Concentrations Achieved Within the First 7 Days of Therapy Associated With Acute Kidney Injury in Children? Knoderer, Chad A.; Nichols, Kristen R.; Lyon, Kelsey C.; Veverka, Megan M.; Wilson, Amy C. // Journal of the Pediatric Infectious Diseases Society;Jun2014, Vol. 3 Issue 2, p127 

    Background In 2008, the empiric vancomycin dosing recommendation in children at our institution was changed from 40 to 60 mg/kg per day. Subsequently, an increased incidence of acute kidney injury (AKI) in patients receiving vancomycin was suspected. The objective of this study was to evaluate...

  • Should we stop using intravenous gentamicin in patients with cystic fibrosis? Goss, Christopher H. // Thorax;Jun2008, Vol. 63 Issue 6, p479 

    The article discusses various reports published within the issue including one by A. Smith on the case-control study of acute renal failure in patients with cystic fibrosis and another by M. Al-Aloul on renal impairment in cystic fibrosis patients due to repeated intravenous aminoglycoside use.

  • Risk factors for acute kidney injury during aminoglycoside therapy in patients with cystic fibrosis. Downes, Kevin; Patil, Neha; Rao, Marepalli; Koralkar, Rajesh; Harris, William; Clancy, John; Goldstein, Stuart; Askenazi, David // Pediatric Nephrology;Oct2015, Vol. 30 Issue 10, p1879 

    Background: Aminoglycoside (AG) therapy is a common cause of acute kidney injury (AKI) in cystic fibrosis (CF) patients. The aim of this study was to identify factors associated with AKI during intravenous AG courses in this population. Methods: This was a matched case-control study utilizing...

  • What is the real impact of acute kidney injury? Bedford, Michael; Stevens, Paul E.; Wheeler, Toby W. K.; Farmer, Christopher K. T. // BMC Nephrology;2014, Vol. 15 Issue 1, preceding p1 

    Background Acute kidney injury (AKI) is a common clinical problem. Studies have documented the incidence of AKI in a variety of populations but to date we do not believe the real incidence of AKI has been accurately documented in a district general hospital setting. The aim here was to describe...

  • Incidence and Characteristics of Acute Kidney Injury in Severe Diabetic Ketoacidosis. Orban, Jean-Christophe; Maizière, Eve-Marie; Ghaddab, Anis; Van Obberghen, Emmanuel; Ichai, Carole // PLoS ONE;Oct2014, Vol. 9 Issue 10, p1 

    Aims: Acute kidney injury is a classical complication of diabetic ketoacidosis. However, to the best of our knowledge, no study has reported the incidence and characteristics of acute kidney injury since the consensus definition was issued. Methods: Retrospective study of all cases of severe...

  • Prevalence of depression and anxiety in patients with cystic fibrosis and parent caregivers: results of The International Depression Epidemiological Study across nine countries. Quittner, Alexandra L.; Goldbeck, Lutz; Abbott, Janice; Duff, Alistair; Lambrecht, Patrick; Solé, Amparo; Tibosch, Marijke M.; Brucefors, Agneta Bergsten; Yüksel, Hasan; Catastini, Paola; Blackwell, Laura; Barker, Dave // Thorax;Dec2014, Vol. 69 Issue 12, p1090 

    Background Individuals with chronic diseases and parent caregivers are at increased risk for symptoms of depression and anxiety. Prevalence of psychological symptoms was evaluated in adolescents and adults with cystic fibrosis (CF) and parent caregivers across nine countries. Methods Patients...

  • Incidence of acute kidney injury following total joint arthroplasty: a retrospective review by RIFLE criteria. Kimmel, Lara A.; Wilson, Scott; Janardan, Jyotsna D.; Liew, Susan M.; Walker, Rowan G. // Clinical Kidney Journal;Dec2014, Vol. 7 Issue 6, p546 

    Background Total joint arthroplasty (TJA) is a common procedure with demand for arthroplasties expected to increase exponentially. Incidence of acute kidney injury (AKI) following TJA is reportedly low, with most studies finding an incidence of <2%, increasing to 9% when emergency orthopaedic...

  • Acute renal failure in cystic fibrosis.  // Archives of Disease in Childhood;Oct2007, Vol. 92 Issue 10, p915 

    The article offers information on the study conducted by the Great Britain cystic fibrosis centers on acute renal failure in patients with cystic fibrosis. The study assesses about 55 possible cases of acute renal failure between 1997 and 2004. This study estimated that the incidence was...

  • Aminoglycosides linked to acute renal failure in CF patients.  // Reactions Weekly;8/11/2007, Issue 1164, p3 

    The article discusses the results of a survey of acute renal failure (ARF) in patients with cystic fibrosis (CF) in Great Britain. The survey found that ARF in patients with CF implicate IV aminoglycosides as an etiological factor. Based on responses, 55 cases were identified with consent given...


Read the Article


Sign out of this library

Other Topics