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Risk Factors for and Characteristics of Community- and Hospital-Acquired Drug-Induced Acute Kidney Injuries.

Abstract : Drugs constitute one of the leading causes of acute kidney injuries (AKIs) and can appear in community (CA-AKI) or hospital (HA-AKI) population. The objectives of the present study of a cohort of hospitalized patients with AKI were to describe the characteristics of drug-induced AKIs and the patients' short-term outcomes and assess risk factors for drug-induced AKIs overall, CA-AKIs, and HA-AKIs. Based on a cohort of 1557 hospitalized patients suffering from AKIs based on PMSI extraction and chart review (IRA-PMSI), drug-induced AKIs were identified by applying the Naranjo adverse drug reaction (ADR) probability scale. Multivariate logistic regression was used to identify factors associated with CA-AKIs and/or HA-AKIs. When considering the 1557 patients who experienced an AKI, 445 (28.6%) of the injuries were drug-induced (180 CA-AKIs (40.4%) and 265 HA-AKIs (59.6%)). Antibiotics, diuretics, and contrast agents were significantly more likely to be involved in HA-AKIs, whereas antineoplastic, lipid-lowering drugs, antidiabetics, and immunosuppressive were significantly more likely to be involved in CA-AKIs. Female sex (odds ratio [OR] [95%CI]\,=\,1.3 [1.04-1.67]), chronic kidney disease (CKD) (OR\,=\,1.8 [1.40-2.67]), and a history of ADRs of any type (OR\,=\,1.3 [1.05-1.73]) were significant risk factors for drug-induced AKIs. CKD was a risk factor for both CA-AKI and HA-AKI. In view of the long-term impact of AKI on the kidneys and the differences between our CA-AKI and HA-AKI subgroups, our present results are interesting for optimizing treatments, limiting the occurrence of CA- and HA-AKIs and (ultimately) reducing healthcare costs.
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https://hal-u-picardie.archives-ouvertes.fr/hal-03735623
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Soumis le : jeudi 21 juillet 2022 - 14:54:05
Dernière modification le : vendredi 5 août 2022 - 11:25:28

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Amayelle Rey, Valérie Gras-Champel, Gabriel Choukroun, Kamel Masmoudi, Sophie Liabeuf. Risk Factors for and Characteristics of Community- and Hospital-Acquired Drug-Induced Acute Kidney Injuries.. Fundamental & Clinical Pharmacology, 2022, 36 (4), pp.750--761. ⟨10.1111/fcp.12758⟩. ⟨hal-03735623⟩

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