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

Abstract

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.

Development and Validation of a Nomogram for Predicting Drug-Induced Acute Kidney Injury in Hospitalized Patients: A Case-Control Study Based on Propensity-Score Matching

“…The pathological mechanism by which NSAIDs precipitate hemodynamically mediated kidney injury is the inhibition of renal prostaglandins, causing renal vasoconstriction to occur preferentially in the afferent arteries ( Khan et al, 2017 ; Guan et al, 2019 ). In addition, use of diuretics was found to be a risk factor for D-AKI in many studies ( Kane-Gill and Goldstein, 2015 ; Caspi et al, 2017 ; Yu et al, 2020 ). The mechanism is to stimulate the sympathetic nervous system and the renin-angiotensin system (RAS), which leads to hemodynamic changes and eventually renal perfusion deficit leading to AKI ( Wang C. et al, 2019 ).…”

“…The ADE-ASAS-2 was based on trigger technology and text recognition technology, which can be connected to the HIS to extract patient information. Detailed descriptions of the ADE-ASAS-2 and its applications have been described in our previous study ( Chen et al, 2020 ; Yu et al, 2020 ). Once the monitoring indicators trigger the inclusion criteria, the system could preliminarily determine whether a patient has developed AKI and indicate early warning signals.…”

“…The ADE-ASAS-2 was based on trigger technology and text recognition technology, which can be connected to the HIS to extract patient information. Detailed descriptions of the ADE-ASAS-2 and its applications have been described in our previous study (Chen et al, 2020;Yu et al, 2020).…”

Kidney damage from nonsteroidal anti‐inflammatory drugs—Myth or truth? Review of selected literature

“…Yu et al conducted a retrospective study, which included 21,131 patients. The authors reported an association between NSAIDs and drug‐induced AKI—OR = 2.39 (95% CI: 1.25–4.58) 26 . Furthermore, Pham et al found that antenatal indomethacin increases the risk of AKI in neonates.…”

Incidence, characteristics and risk factors for drug‐induced liver injury in hospitalized patients: A matched case‐control study

“…The causality score ranges from −9 to 14 points. The scores are divided into highly probable (≥9), probable (6)(7)(8), possible (3)(4)(5), unlikely (1)(2) or excluded (<0). 4 Patients with RUCAM ≥ 6 points were directly included in the case group, and patients with RUCAM scores of 3-5 points were evaluated back-to-back again by the investigator based on the patient's medical history and disease progression.…”