The Effect of Curcumin Against Colistin-induced Nephrotoxicity

Inclusion Criteria: All critically ill adult patients (18-65 years old) who are infected by MDR Gram-negative bacteria and require intravenous colistin therapy Exclusion Criteria: Patients receiving intravenous colistin therapy for < 72 hours. Patients receiving renal replacement therapy (RRT). Patients with diseases that may contribute to renal impairment such as systemic lupus erythematosus, acute myocardial infarction, cancer, HIV infection, glucose-6-phosphate-dehydrogenase deficiency, or urinary tract stone. Pregnancy or breastfeeding. Known allergy to the study medications. Patients with chronic kidney diseases (creatinine clearance < 60 mg/dL). Elevated total liver enzymes (AST, and ALT) three times above the upper limit of normal. Patients with acute decompensated heart failure signs and symptoms requiring intravenous loop diuretics and/or intravenous inotropes and/or ACE inhibitors. Uncontrolled diabetes (Glycosylated hemoglobin (Hb A1C) >8%). Hypotensive patients defined as decrease in blood pressure less than 90/60 mm Hg. Recent use of vitamins with antioxidant properties such as beta carotene, vitamin E, vitamin C, selenium, or N-acetylcysteine or any other medications known to have nephroprotective activities. Patients receiving other nephrotoxic drugs at enrollment (e.g., aminoglycosides, vancomycin, or amphotericin B) or administration of contrast medium within 7 days.