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Community-acquired acute kidney injury induced by drugs in older patients: a multifactorial event

Laurine Robert 1 Gregoire Ficheur 1 Sophie Gautier 2 Alexandre Servais 1 Michel Luyckx 3 Julien Soula 1 Bertrand Decaudin 3 Francois-Xavier Glowacki 4 Francois Puisieux 1 Emmanuel Chazard 1 Jean-Baptiste Beuscart 1
1 METRICS - Evaluation des technologies de santé et des pratiques médicales - ULR 2694
2 TCDV - Troubles cognitifs dégénératifs et vasculaires - U 1171
3 GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées - ULR 7365
4 IMPECS - Impact de l'environnement chimique sur la santé humaine - ULR 4483
Abstract : 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.
Keywords : adverse drug reactions elderly prevention acute kidney injury
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https://hal.univ-lille.fr/hal-03394703
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Soumis le : vendredi 22 octobre 2021 - 10:51:45
Dernière modification le : mercredi 23 mars 2022 - 15:51:27
Archivage à long terme le : : dimanche 23 janvier 2022 - 19:03:03

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UNIV-LILLE | INSERM

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Laurine Robert, Gregoire Ficheur, Sophie Gautier, Alexandre Servais, Michel Luyckx, et al.. Community-acquired acute kidney injury induced by drugs in older patients: a multifactorial event. Clinical interventions in aging, 2019, Clinical interventions in aging, 14, pp.2105-2113. ⟨10.2147/CIA.S217567⟩. ⟨hal-03394703⟩

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