scholarly journals Clinical Characteristics of Hospitalized Patients with Drug-Induced Acute Kidney Injury and Associated Risk Factors: A Case-Control Study

2020 ◽  
Vol 2020 ◽  
pp. 1-8 ◽  
Author(s):  
Chengxuan Yu ◽  
Daihong Guo ◽  
Chong Yao ◽  
Hongyi Yang ◽  
Siyuan Liu ◽  
...  

Background. Drug-induced acute kidney injury (D-AKI) is increasingly common and can extend the hospital length of stay and increase mortality. This study is aimed at analyzing the clinical characteristics of hospitalized patients with D-AKI and the associated risk factors in a multidrug environment. Methods. A retrospective study among hospitalized patients was conducted in July 2019 based on the Adverse Drug Events Active Surveillance and Assessment System-2 developed by the authors. Four controls were matched with each case according to the matching criteria. The risk factors for D-AKI were identified by binary multivariate logistic regression. Results. A total of 23,073 patients were hospitalized in July 2019, 21,131 of whom satisfied the inclusion criteria. The independent risk factors for D-AKI consisted of alcohol abuse (odds ratio (OR), 2.05; 95% confidence interval (CI), 1.04-4.07), nonsteroidal anti-inflammatory drug (NSAID) use (OR, 2.39; 95% CI, 1.25-4.58), diuretic use (OR, 2.64; 95% CI, 1.42-4.92), prior anemia (OR, 4.10; 95% CI, 1.94-8.67), and prior chronic kidney disease (OR, 2.33; 95% CI, 1.07-5.08). Conclusions. The occurrence of D-AKI in hospitalized patients had significant associations with alcohol abuse, combination therapy with NSAIDs or diuretics, and prior anemia or chronic kidney disease. Clinicians should meticulously follow patients with the above characteristics.

Medicine ◽  
2015 ◽  
Vol 94 (45) ◽  
pp. e2025 ◽  
Author(s):  
Jia-Rui Xu ◽  
Jia-Ming Zhu ◽  
Jun Jiang ◽  
Xiao-Qiang Ding ◽  
Yi Fang ◽  
...  

2018 ◽  
Vol 48 (10) ◽  
pp. e12999
Author(s):  
Tobias Breidthardt ◽  
Cedric Jaeger ◽  
Andreas Christ ◽  
Theresia Klima ◽  
Tamina Mosimann ◽  
...  

2016 ◽  
Vol 31 (suppl_1) ◽  
pp. i19-i19
Author(s):  
Silvia Gonzalez Sanchidrian ◽  
Pedro Jesus Labrador Gomez ◽  
Jesus Pedro Marin Alvarez ◽  
Maria Del Carmen Jiménez Herrero ◽  
Elena Davin Carrero ◽  
...  

2018 ◽  
Vol 35 (4) ◽  
pp. 338-346 ◽  
Author(s):  
Stefan Büttner ◽  
Andrea Stadler ◽  
Christoph Mayer ◽  
Sammy Patyna ◽  
Christoph Betz ◽  
...  

Purpose: Acute kidney injury (AKI) is a severe complication in medical and surgical intensive care units accounting for a high morbidity and mortality. Incidence, risk factors, and prognostic impact of this deleterious condition are well established in this setting. Data concerning the neurocritically ill patients is scarce. Therefore, aim of this study was to determine the incidence of AKI and elucidate risk factors in this special population. Methods: Patients admitted to a specialized neurocritical care unit between 2005 and 2011 with a length of stay above 48 hours were analyzed retrospectively for incidence, cause, and outcome of AKI (AKI Network-stage ≥2). Results: The study population comprised 681 neurocritically ill patients from a mixed neurosurgical and neurological intensive care unit. The prevalence of chronic kidney disease (CKD) was 8.4% (57/681). Overall incidence of AKI was 11.6% with 36 (45.6%) patients developing dialysis-requiring AKI. Sepsis was the main cause of AKI in nearly 50% of patients. Acute kidney injury and renal replacement therapy are independent predictors of worse outcome (hazard ratio [HR]: 3.704; 95% confidence interval [CI]: 1.867-7.350; P < .001; and HR: 2.848; CI: 1.301-6.325; P = .009). Chronic kidney disease was the strongest independent risk factor (odds ratio: 12.473; CI: 5.944-26.172; P < .001), whereas surgical intervention or contrast agents were not associated with AKI. Conclusions: Acute kidney injury in neurocritical care has a high incidence and is a crucial risk factor for mortality independently of the underlying neurocritical condition. Sepsis is the main cause of AKI in this setting. Therefore, careful prevention of infectious complications and considering CKD in treatment decisions may lower the incidence of AKI and hereby improve outcome in neurocritical care.


Author(s):  
Joana Gameiro ◽  
José Agapito Fonseca ◽  
João Oliveira ◽  
Filipe Marques ◽  
João Bernardo ◽  
...  

Abstract Introduction: The incidence of AKI in coronavirus disease 2019 (COVID-19) patients ranges from 0.5 to 35% and has been associated with worse prognosis. The purpose of this study was to evaluate the incidence, severity, duration, risk factors and prognosis of AKI in hospitalized patients with COVID-19.Methods: We conducted a retrospective single-center analysis of 192 hospitalized COVID-19 patients from March to May of 2020. AKI was diagnosed using the Kidney Disease Improving Global Outcome (KDIGO) classification based on serum creatinine (SCr) criteria. Persistent and Transient AKI were defined according to the Acute Disease Quality Initiative (ADQI) workgroup definitions.Results: In this cohort of COVID-19 patients, 55.2% developed AKI (n=106). The majority of AKI patients had persistent AKI (n=64, 60.4%). Overall, in-hospital mortality was 18.2% (n=35) and was higher in AKI patients (28.3% vs 5.9%, p<0.001, unadjusted OR 6.03 (2.22-16.37), p<0.001). On a multivariate analysis, older age (adjusted OR 1.08 (95% CI 1.02-1.13), p=0.004), lower Hb level (adjusted OR 0.69 (95% CI 0.53-0.91), p=0.007) and acidemia at presentation (adjusted OR 5.53 (95% CI 1.70-18.63), p=0.005), duration of AKI (adjusted OR 7.91 for persistent AKI (95% CI 2.39-26.21), p=0.001) and severity of AKI (adjusted OR 2.30 per increase in KDIGO stage (95% CI 1.10-4.82), p=0.027) were independent predictors of mortality.Conclusion: AKI was frequent in hospitalized patients with COVID-19. Persistent AKI and higher severity of AKI were independent predictors of in-hospital mortality.


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