Cargando…

Hospitalisation Due to Community-Acquired Acute Kidney Injury and the Role of Medications: A Retrospective Audit

The aim of this study is to assess the use of high-risk medications in patients with community-acquired acute kidney injury (CA-AKI) and the differences in the characteristics and outcomes of CA-AKI based on the use of these medications. This is a retrospective audit of adults (≥35 years) with CA-AK...

Descripción completa

Detalles Bibliográficos
Autores principales: Duong, Henna, Tesfaye, Wubshet, Van, Connie, Sud, Kamal, Castelino, Ronald L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10179015/
https://www.ncbi.nlm.nih.gov/pubmed/37176787
http://dx.doi.org/10.3390/jcm12093347
_version_ 1785040998091456512
author Duong, Henna
Tesfaye, Wubshet
Van, Connie
Sud, Kamal
Castelino, Ronald L.
author_facet Duong, Henna
Tesfaye, Wubshet
Van, Connie
Sud, Kamal
Castelino, Ronald L.
author_sort Duong, Henna
collection PubMed
description The aim of this study is to assess the use of high-risk medications in patients with community-acquired acute kidney injury (CA-AKI) and the differences in the characteristics and outcomes of CA-AKI based on the use of these medications. This is a retrospective audit of adults (≥35 years) with CA-AKI admitted to a large tertiary care hospital over a two-year period. We investigated the prevalence of SADMANS (sulfonylureas; angiotensin converting enzyme inhibitors; diuretics; metformin; angiotensin receptor blockers; nonsteroidal anti-inflammatory drugs; and sodium glucose co-transporter 2 inhibitors) medications use in people with CA-AKI prior to hospitalisation. Outcomes including CA-AKI severity, kidney function recovery and in-hospital mortality were examined and stratified by use of SADMANS medications. The study included 329 patients, with a mean (SD) age of 75 (12) years and a 52% proportion of females, who were hospitalised with CA-AKI. Most patients (77.5%) were taking at least one regular SADMANS medication upon admission. Overall, 40% of patients (n = 132) and 41% of those on SADMANS (n = 104) had hypovolaemia or associated symptoms such as vomiting and diarrhoea during admission. Over two-thirds (68.1%) had mild AKI on admission and patients who were taking SADMANS medications were more likely to have mild AKI. Patients on SADMANS had more comorbidities and a higher medication burden, but there were no differences in AKI severity on admission or outcomes such as length of hospitalisation, ICU admission, need for dialysis, recovery rates and mortality between the two groups. However, the high prevalence of SADMANS medications use among patients with CA-AKI indicates a potential for preventability of CA-AKI-led hospitalisations. Future studies are needed to gain better insights into the role of withholding this group of medications, especially during an acute illness.
format Online
Article
Text
id pubmed-10179015
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-101790152023-05-13 Hospitalisation Due to Community-Acquired Acute Kidney Injury and the Role of Medications: A Retrospective Audit Duong, Henna Tesfaye, Wubshet Van, Connie Sud, Kamal Castelino, Ronald L. J Clin Med Article The aim of this study is to assess the use of high-risk medications in patients with community-acquired acute kidney injury (CA-AKI) and the differences in the characteristics and outcomes of CA-AKI based on the use of these medications. This is a retrospective audit of adults (≥35 years) with CA-AKI admitted to a large tertiary care hospital over a two-year period. We investigated the prevalence of SADMANS (sulfonylureas; angiotensin converting enzyme inhibitors; diuretics; metformin; angiotensin receptor blockers; nonsteroidal anti-inflammatory drugs; and sodium glucose co-transporter 2 inhibitors) medications use in people with CA-AKI prior to hospitalisation. Outcomes including CA-AKI severity, kidney function recovery and in-hospital mortality were examined and stratified by use of SADMANS medications. The study included 329 patients, with a mean (SD) age of 75 (12) years and a 52% proportion of females, who were hospitalised with CA-AKI. Most patients (77.5%) were taking at least one regular SADMANS medication upon admission. Overall, 40% of patients (n = 132) and 41% of those on SADMANS (n = 104) had hypovolaemia or associated symptoms such as vomiting and diarrhoea during admission. Over two-thirds (68.1%) had mild AKI on admission and patients who were taking SADMANS medications were more likely to have mild AKI. Patients on SADMANS had more comorbidities and a higher medication burden, but there were no differences in AKI severity on admission or outcomes such as length of hospitalisation, ICU admission, need for dialysis, recovery rates and mortality between the two groups. However, the high prevalence of SADMANS medications use among patients with CA-AKI indicates a potential for preventability of CA-AKI-led hospitalisations. Future studies are needed to gain better insights into the role of withholding this group of medications, especially during an acute illness. MDPI 2023-05-08 /pmc/articles/PMC10179015/ /pubmed/37176787 http://dx.doi.org/10.3390/jcm12093347 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Duong, Henna
Tesfaye, Wubshet
Van, Connie
Sud, Kamal
Castelino, Ronald L.
Hospitalisation Due to Community-Acquired Acute Kidney Injury and the Role of Medications: A Retrospective Audit
title Hospitalisation Due to Community-Acquired Acute Kidney Injury and the Role of Medications: A Retrospective Audit
title_full Hospitalisation Due to Community-Acquired Acute Kidney Injury and the Role of Medications: A Retrospective Audit
title_fullStr Hospitalisation Due to Community-Acquired Acute Kidney Injury and the Role of Medications: A Retrospective Audit
title_full_unstemmed Hospitalisation Due to Community-Acquired Acute Kidney Injury and the Role of Medications: A Retrospective Audit
title_short Hospitalisation Due to Community-Acquired Acute Kidney Injury and the Role of Medications: A Retrospective Audit
title_sort hospitalisation due to community-acquired acute kidney injury and the role of medications: a retrospective audit
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10179015/
https://www.ncbi.nlm.nih.gov/pubmed/37176787
http://dx.doi.org/10.3390/jcm12093347
work_keys_str_mv AT duonghenna hospitalisationduetocommunityacquiredacutekidneyinjuryandtheroleofmedicationsaretrospectiveaudit
AT tesfayewubshet hospitalisationduetocommunityacquiredacutekidneyinjuryandtheroleofmedicationsaretrospectiveaudit
AT vanconnie hospitalisationduetocommunityacquiredacutekidneyinjuryandtheroleofmedicationsaretrospectiveaudit
AT sudkamal hospitalisationduetocommunityacquiredacutekidneyinjuryandtheroleofmedicationsaretrospectiveaudit
AT castelinoronaldl hospitalisationduetocommunityacquiredacutekidneyinjuryandtheroleofmedicationsaretrospectiveaudit