Drug-Induced Hospital-Acquired Acute Kidney Injury in China: A Multicenter Cross-Sectional Survey

被引：63

作者：

Liu, Chen ^{[1
]}

Yan, Suying ^{[1
]}

Wang, Yuqin ^{[1
]}

Wang, Jinwei ^{[2
]}

Fu, Xiujuan ^{[3
]}

Song, Hongtao ^{[4
]}

Tong, Rongsheng ^{[5
]}

Dong, Mei ^{[6
]}

Ge, Weihong ^{[7
]}

Wang, Jiawei ^{[8
]}

Yang, Hui ^{[9
]}

Wang, Changlian ^{[10
]}

Xia, Peiyuan ^{[11
]}

Zhao, Limei ^{[12
]}

Shen, Sijing ^{[13
]}

Xie, Juan ^{[14
]}

Xu, Yangui ^{[15
]}

Ma, Peizhi ^{[16
]}

Li, Hongjian ^{[17
]}

Lu, Shegui ^{[18
]}

Ding, Yufeng ^{[19
]}

Jiang, Ling ^{[20
]}

Lin, Yang ^{[21
]}

Wang, Maoyi ^{[22
]}

Qiu, Feng ^{[23
]}

Feng, Wanyu ^{[24
]}

Yang, Li ^{[2
]}

机构：

[1] Capital Med Univ, Xuanwu Hosp, Dept Pharm, 45 Changchun St, Beijing 100053, Peoples R China

[2] Peking Univ, Peking Univ First Hosp, Renal Div, 8 Xishiku St, Beijing 100034, Peoples R China

[3] Jilin Univ, Hosp 2, Dept Pharm, Changchun, Peoples R China

[4] 900 Hosp Joint Logist Team, Dept Pharm, Fuzhou, Peoples R China

[5] Sichuan Prov Peoples Hosp, Dept Pharm, Chengdu, Peoples R China

[6] Harbin Med Univ, Dept Pharm, Affiliated Tumor Hosp, Harbin, Peoples R China

[7] Nanjing Drum Tower Hosp, Dept Pharm, Nanjing, Peoples R China

[8] Beijing Tongren Hosp, Dept Pharm, Beijing, Peoples R China

[9] Qinghai Univ, Dept Pharm, Affiliated Hosp, Xining, Peoples R China

[10] Fujian Med Univ, Affiliated Hosp 1, Dept Pharm, Fuzhou, Peoples R China

[11] Army Med Univ, Hosp 1, Dept Pharm, Chongqing, Peoples R China

[12] China Med Univ, Dept Pharm, Shengjing Hosp, Shenyang, Peoples R China

[13] Peking Univ, Dept Pharm, Shougang Hosp, Beijing, Peoples R China

[14] Guizhou Prov Peoples Hosp, Dept Pharm, Guiyang, Peoples R China

[15] Tianjin First Ctr Hosp, Dept Pharm, Tianjin, Peoples R China

[16] Henan Prov Peoples Hosp, Dept Pharm, Zhengzhou, Peoples R China

[17] Shandong Prov Qianfoshan Hosp, Dept Pharm, Jinan, Peoples R China

[18] Nanchang Univ, Dept Pharm, Hosp 2, Nanchang, Jiangxi, Peoples R China

[19] Huazhong Univ Sci, Tongji Affiliated Hosp, Dept Pharm, Tongji Med Coll, Wuhan, Peoples R China

[20] Anhui Prov Hosp, Dept Pharm, Hefei, Peoples R China

[21] Beijing Anzhen Hosp, Dept Pharm, Beijing, Peoples R China

[22] Xi An Jiao Tong Univ, Dept Pharm, Affiliated Hosp 1, Xian, Peoples R China

[23] Chongqing Med Univ, Dept Pharm, Affiliated Hosp 1, Chongqing, Peoples R China

[24] Peking Univ Peoples Hosp, Dept Pharm, Beijing, Peoples R China

来源：

KIDNEY DISEASES | 2021年 / 7卷 / 02期

基金：

中国国家自然科学基金;

关键词：

Drug-induced acute kidney injury; Hospital-acquired acute kidney injury;

D O I：

10.1159/000510455

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

100201 [内科学]; 100221 [泌尿外科学];

摘要：

Introduction: Drug-induced acute kidney injury (D-AKI) is one of the important types of AKI. The incidence of D-AKI in China has rarely been studied. Objective: This study aims to explore the disease burden, related drugs, and risk factors of D-AKI. Methods: A nationwide cross-sectional survey was conducted in adult patients from 23 academic hospitals in 17 provinces in China. Suspected AKI was screened based on serum creatinine changes in accordance with the 2012 Kidney Disease: Improving Global Outcomes Clinical Practice Guideline for AKI, patients who met the diagnosis of hospital-acquired AKI in January and July of 2014 were defined. Suspected AKI was firstly evaluated for the possibility of D-AKI by pharmacists using the Naranjo Scale and finally defined as D-AKI by nephrologists through reviewing AKI clinical features. Results: Altogether 280,255 hospitalized patients were screened and 1,960 cases were diagnosed as hospital-acquired AKI, among which 735 cases were defined as having D-AKI (37.50%, 735/1,960) with an in-hospital mortality rate of 13.88% and 54.34% of the survivors did not achieve full renal recovery. 1,642 drugs were related to AKI in these patients. Anti-infectives, diuretics, and proton pump inhibitors were the top 3 types of drugs relevant to D-AKI, accounting for 66.63% cumulatively. Besides age, AKI staging, severe disease, hypoalbuminemia, plasma substitute, and carbapenem related D-AKI were independent risk factors for in-hospital mortality of D-AKI patients. Conclusion: In China, D-AKI has caused a substantial medical burden. Efforts should be made to pursue nephrotoxic drug stewardship to minimize attributable risk and improve the prevention, diagnosis, and treatment of D-AKI.

引用

页码：143 / 155

页数：13

共 29 条

[1]

The 6R's of drug induced nephrotoxicity [J].