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Community-Acquired Acute Kidney Injury Induced By Drugs In Older Patients: A Multifactorial Event

PURPOSE: Community-acquired acute kidney injury (CA-AKI) is a frequent and severe adverse drug reaction (ADR) among older patients. The combination of drugs and other CA-AKI risk factors was barely evaluated. The objectives of our study were to both accurately identify CA-AKI induced by drugs in old...

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Autores principales: Robert, Laurine, Ficheur, Grégoire, Gautier, Sophie, Servais, Alexandre, Luyckx, Michel, Soula, Julien, Decaudin, Bertrand, Glowacki, François, Puisieux, François, Chazard, Emmanuel, Beuscart, Jean-Baptiste
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6901120/
https://www.ncbi.nlm.nih.gov/pubmed/31824141
http://dx.doi.org/10.2147/CIA.S217567
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author Robert, Laurine
Ficheur, Grégoire
Gautier, Sophie
Servais, Alexandre
Luyckx, Michel
Soula, Julien
Decaudin, Bertrand
Glowacki, François
Puisieux, François
Chazard, Emmanuel
Beuscart, Jean-Baptiste
author_facet Robert, Laurine
Ficheur, Grégoire
Gautier, Sophie
Servais, Alexandre
Luyckx, Michel
Soula, Julien
Decaudin, Bertrand
Glowacki, François
Puisieux, François
Chazard, Emmanuel
Beuscart, Jean-Baptiste
author_sort Robert, Laurine
collection PubMed
description PURPOSE: Community-acquired acute kidney injury (CA-AKI) is a frequent and severe adverse drug reaction (ADR) among older patients. The combination of drugs and other CA-AKI risk factors was barely evaluated. The objectives of our study were to both accurately identify CA-AKI induced by drugs in older patients, and to describe their combination with other risk factors. PATIENTS AND METHODS: We conducted a retrospective, single-center study in a general hospital over a two-year period. An automated detection identified CA-AKI according to KDIGO criteria, amongst 4,767 eligible inpatient stays among patients aged 75 years or older. Two independent experts reviewed all CA-AKI events to adjudicate drug involvement (Naranjo scale), identify inappropriate prescriptions (STOPP criteria), evaluate avoidability (Hallas criteria) and identify combined risk factors. RESULTS: An expert review confirmed 713 CA-AKI (15.0% of inpatient stays) and determined that 419 (58.8%) CA-AKI were induced by drugs. A multifactorial cause (i.e., at least one drug with a precipitating factor) was found in 63.2% of drug-induced CA-AKI. Most of the drug-induced events were avoidable (66.8%), mainly in relation to a multifactorial cause. CONCLUSION: Drug-induced CA-AKI were frequent, multifactorial events in hospitalized older patients and their prevention should focus on combinations with precipitating factors.
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spelling pubmed-69011202019-12-10 Community-Acquired Acute Kidney Injury Induced By Drugs In Older Patients: A Multifactorial Event Robert, Laurine Ficheur, Grégoire Gautier, Sophie Servais, Alexandre Luyckx, Michel Soula, Julien Decaudin, Bertrand Glowacki, François Puisieux, François Chazard, Emmanuel Beuscart, Jean-Baptiste Clin Interv Aging Original Research PURPOSE: Community-acquired acute kidney injury (CA-AKI) is a frequent and severe adverse drug reaction (ADR) among older patients. The combination of drugs and other CA-AKI risk factors was barely evaluated. The objectives of our study were to both accurately identify CA-AKI induced by drugs in older patients, and to describe their combination with other risk factors. PATIENTS AND METHODS: We conducted a retrospective, single-center study in a general hospital over a two-year period. An automated detection identified CA-AKI according to KDIGO criteria, amongst 4,767 eligible inpatient stays among patients aged 75 years or older. Two independent experts reviewed all CA-AKI events to adjudicate drug involvement (Naranjo scale), identify inappropriate prescriptions (STOPP criteria), evaluate avoidability (Hallas criteria) and identify combined risk factors. RESULTS: An expert review confirmed 713 CA-AKI (15.0% of inpatient stays) and determined that 419 (58.8%) CA-AKI were induced by drugs. A multifactorial cause (i.e., at least one drug with a precipitating factor) was found in 63.2% of drug-induced CA-AKI. Most of the drug-induced events were avoidable (66.8%), mainly in relation to a multifactorial cause. CONCLUSION: Drug-induced CA-AKI were frequent, multifactorial events in hospitalized older patients and their prevention should focus on combinations with precipitating factors. Dove 2019-12-05 /pmc/articles/PMC6901120/ /pubmed/31824141 http://dx.doi.org/10.2147/CIA.S217567 Text en © 2019 Robert et al. http://creativecommons.org/licenses/by-nc/3.0/ This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Robert, Laurine
Ficheur, Grégoire
Gautier, Sophie
Servais, Alexandre
Luyckx, Michel
Soula, Julien
Decaudin, Bertrand
Glowacki, François
Puisieux, François
Chazard, Emmanuel
Beuscart, Jean-Baptiste
Community-Acquired Acute Kidney Injury Induced By Drugs In Older Patients: A Multifactorial Event
title Community-Acquired Acute Kidney Injury Induced By Drugs In Older Patients: A Multifactorial Event
title_full Community-Acquired Acute Kidney Injury Induced By Drugs In Older Patients: A Multifactorial Event
title_fullStr Community-Acquired Acute Kidney Injury Induced By Drugs In Older Patients: A Multifactorial Event
title_full_unstemmed Community-Acquired Acute Kidney Injury Induced By Drugs In Older Patients: A Multifactorial Event
title_short Community-Acquired Acute Kidney Injury Induced By Drugs In Older Patients: A Multifactorial Event
title_sort community-acquired acute kidney injury induced by drugs in older patients: a multifactorial event
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6901120/
https://www.ncbi.nlm.nih.gov/pubmed/31824141
http://dx.doi.org/10.2147/CIA.S217567
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