{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T21:58:37Z","timestamp":1777327117200,"version":"3.51.4"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2024,7,1]],"date-time":"2024-07-01T00:00:00Z","timestamp":1719792000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Nature Science Foundation of China","doi-asserted-by":"publisher","award":["82304636"],"award-info":[{"award-number":["82304636"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004761","name":"Nature Science Foundation of Hunan Province","doi-asserted-by":"crossref","award":["2023JJ40911"],"award-info":[{"award-number":["2023JJ40911"]}],"id":[{"id":"10.13039\/501100004761","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Polymyxin-induced nephrotoxicity (PIN) is a major safety concern and challenge in clinical practice, which limits the clinical use of polymyxins. This study aims to investigate the risk factors and to develop a scoring tool for the early prediction of PIN.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Data on critically ill patients who received intravenous polymyxin B or colistin sulfate for over 24 h were collected. Logistic regression with the least absolute shrinkage and selection operator (LASSO) was used to identify variables that are associated with outcomes. The eXtreme Gradient Boosting (XGB) classifier algorithm was used to further visualize factors with significant differences. A prediction model for PIN was developed through binary logistic regression analysis and the model was assessed by temporal validation and external validation. Finally, a risk-scoring system was developed based on the prediction model.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 508 patients, 161 (31.6%) patients developed PIN. Polymyxin type, loading dose, septic shock, concomitant vasopressors and baseline blood urea nitrogen (BUN) level were identified as significant predictors of PIN. All validation exhibited great discrimination, with the AUC of 0.742 (95% CI: 0.696\u20130.787) for internal validation, of 0.708 (95% CI: 0.605\u20130.810) for temporal validation and of 0.874 (95% CI: 0.759\u20130.989) for external validation, respectively. A simple risk-scoring tool was developed with a total risk score ranging from \u22123 to 4, corresponding to a risk of PIN from 0.79% to 81.24%.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>This study established a prediction model for PIN. Before using polymyxins, the simple risk-scoring tool can effectively identify patients at risk of developing PIN within a range of 7% to 65%.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jac\/dkae185","type":"journal-article","created":{"date-parts":[[2024,7,1]],"date-time":"2024-07-01T07:14:32Z","timestamp":1719818072000},"page":"1919-1928","source":"Crossref","is-referenced-by-count":5,"title":["A pilot clinical risk model to predict polymyxin-induced nephrotoxicity: a real-world, retrospective cohort study"],"prefix":"10.1093","volume":"79","author":[{"given":"Mong-Hsiu","family":"Song","sequence":"first","affiliation":[{"name":"Department of Pharmacy, The Third Xiangya Hospital of Central South University , Changsha, Hunan 410013 , China"},{"name":"Xiangya School of Pharmaceutical Sciences, Central South University , Changsha, Hunan 410013 , China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bi-Xiao","family":"Xiang","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, The Third Xiangya Hospital of Central South University , Changsha, Hunan 410013 , China"},{"name":"College of Pharmacy, Zunyi Medical University , Zunyi, Guizhou 563003 , China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chien-Yi","family":"Yang","sequence":"additional","affiliation":[{"name":"Xiangya School of Pharmaceutical Sciences, Central South University , Changsha, Hunan 410013 , China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chou-Hsi","family":"Lee","sequence":"additional","affiliation":[{"name":"Xiangya School of Medicine, Central South University , Changsha, Hunan 410013 , China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu-Xuan","family":"Yan","sequence":"additional","affiliation":[{"name":"Xiangya School of Pharmaceutical Sciences, Central South University , Changsha, Hunan 410013 , China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qin-Jie","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, The Third Xiangya Hospital of Central South University , Changsha, Hunan 410013 , China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wen-Jun","family":"Yin","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, The Third Xiangya Hospital of Central South University , Changsha, Hunan 410013 , China"},{"name":"Department of Pharmacy and Center of Clinical Pharmacology, The Third Xiangya Hospital, Central South University , Changsha, Hunan 410013 , China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yangang","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, The Second Xiangya Hospital, Central South University , Changsha, Hunan 410011 , China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiao-Cong","family":"Zuo","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, The Third Xiangya Hospital of Central South University , Changsha, Hunan 410013 , China"},{"name":"Department of Pharmacy and Center of Clinical Pharmacology, The Third Xiangya Hospital, Central South University , Changsha, Hunan 410013 , China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6178-8722","authenticated-orcid":false,"given":"Yue-Liang","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, The Third Xiangya Hospital of Central South University , Changsha, Hunan 410013 , China"},{"name":"Department of Pharmacy and Center of Clinical Pharmacology, The Third Xiangya Hospital, Central South University , Changsha, Hunan 410013 , 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