NDLI: Adverse drug events during AKI and its recovery.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Cox, Zachary L. McCoy, Allison B. Matheny, Michael E. Bhave, Gautam Peterson, Neeraja B. Siew, Edward D. Lewis, Julia Danciu, Ioana Bian, Aihua Shintani, Ayumi Ikizler, T. Alp Neal, Erin B. Peterson, Josh F.
Spatial Coverage	Tennessee
Description	Country affiliation: United States Author Affiliation: Cox ZL ( Department of Pharmacy, Vanderbilt University Medical Center, Nashville, Tennessee, USA. zachary.l.cox@vanderbilt.edu)
Abstract	BACKGROUND AND OBJECTIVES: The impact of AKI on adverse drug events and therapeutic failures and the medication errors leading to these events have not been well described. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: A single-center observational study of 396 hospitalized patients with a minimum 0.5 mg/dl change in serum creatinine who were prescribed a nephrotoxic or renally eliminated medication was conducted. The population was stratified into two groups by the direction of their initial serum creatinine change: AKI and AKI recovery. Adverse drug events, potential adverse drug events, therapeutic failures, and potential therapeutic failures for 148 drugs and 46 outcomes were retrospectively measured. Events were classified for preventability and severity by expert adjudication. Multivariable analysis identified medication classes predisposing AKI patients to adverse drug events. RESULTS: Forty-three percent of patients experienced a potential adverse drug event, adverse drug event, therapeutic failure, or potential therapeutic failure; 66% of study events were preventable. Failure to adjust for kidney function (63%) and use of nephrotoxic medications during AKI (28%) were the most common potential adverse drug events. Worsening AKI and hypotension were the most common preventable adverse drug events. Most adverse drug events were considered serious (63%) or life-threatening (31%), with one fatal adverse drug event. Among AKI patients, administration of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, antibiotics, and antithrombotics was most strongly associated with the development of an adverse drug event or potential adverse drug event. CONCLUSIONS: Adverse drug events and potential therapeutic failures are common and frequently severe in patients with AKI exposed to nephrotoxic or renally eliminated medications.
File Format	HTM / HTML
ISSN	15559041
e-ISSN	1555905X
DOI	10.2215/CJN.11921112
Journal	Clinical Journal of the American Society of Nephrology
Issue Number	7
Volume Number	8
Language	English
Publisher	American Society of Nephrology
Publisher Date	2013-07-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Research Support, N.i.h., Extramural Therapy Multivariate Analysis Biological Markers Tennessee Kidney Blood Drug-related Side Effects And Adverse Reactions Drug Dosage Calculations Time Factors Etiology Treatment Failure Diagnosis Medication Errors Creatinine Research Support, U.s. Gov't, Non-p.h.s. Acute Kidney Injury Glomerular Filtration Rate Inappropriate Prescribing Complications Prevention & Control Mortality Risk Factors Discipline Nephrology Linear Models Logistic Models Hospitalization Metabolism Hypotension Chemically Induced Physiopathology Observational Study
Content Type	Text
Resource Type	Article
Subject	Transplantation Critical Care and Intensive Care Medicine Nephrology Epidemiology

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