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

39 Pages Posted: 2 Dec 2019

See all articles by Chen Liu

Chen Liu

Capital Medical University

Suying Yan

Capital Medical University

Jinwei Wang

Peking University - Renal Division

Xiujuan Fu

Jilin University (JLU)

Hongtao Song

900 Hospital of the Joint Logistics Team

Rongsheng Tong

Sichuan Provincial People's Hospital

Mei Dong

Harbin Medical University

Weihong Ge

Nanjing University

Jiawei Wang

Beijing Tongren Hospital

Hui Yang

Affiliated Hospital of Qinghai University

Changlian Wang

Fujian Medical University

Peiyuan Xia

Army Medical University

Limei Zhao

China Medical University - Department of Pharmacy

Sijing Shen

Peking University

Juan Xie

Guizhou Provincial People's Hospital

Yangui Xu

Tianjin First Central Hospital

Peizhi Ma

Henan Provincial Peoples Hospital

Hongjian Li

Qianfoshan Hospital of Shandong Province

Shegui Lu

Nanchang University

Yufeng Ding

Huazhong University of Science and Technology (Formerly Tongi Medical University)

Ling Jiang

Anhui Provincial Hospital

Yang Lin

Beijing Anzhen Hospital

Maoyi Wang

Xi'an Jiaotong University (XJTU)

Feng Qiu

Chongqing Medical University

Wanyu Feng

Peking University

Li Yang

Peking University - Renal Division

More...

Abstract

Background: Acute kidney injury (AKI) is a severe kidney disease. Drug-induced AKI (D-AKI) is one type of AKI, which is difficult to be diagnosed. The incidence of D-AKI in China has rarely been studied. This study aims to explore the disease burden, related drugs and diagnosis status of D-AKI.

Methods: A nationwide cross-sectional survey was conducted in adult patients from 23 academic hospitals in 17 provinces in mainland China. Suspected AKI was screened based on serum creatinine changes according to the 2012 Kidney Disease: Improving Global Outcomes (KDIGO) Clinical Practice Guideline for Acute Kidney Injury and patients who met the diagnosis of hospital-acquired AKI in January and July of 2014 were defined. D-AKI was firstly evaluated by pharmacists using Naranjo Adverse Drug Reaction Probability Scale and further confirmed by nephrologists through carefully reviewing the medical records.

Findings: Altogether 280,255 hospitalized patients were screened and 1960 cases were diagnosed as hospital-acquired AKI, among which 735 cases were defined as D-AKI (37.50%, 735/1960) with a hospital mortality rate of 13.88% and 54.34% of the survivors not achieving full renal recovery. 1642 drugs were related to AKI in these 735 D-AKI patients. Anti-infectives (34.35%, 564/1642), diuretics (21.80%, 358/1642) and proton pump inhibitors (PPIs) (10.48%, 172/1642) were the top 3 types of drugs relavent to D-AKI, accounting for 66.63% cumulatively. Besides age, AKI staging, severe disease, hypoalbuminemia, plasma substitutes and carbapenems related D-AKI were independent risk factors for in-hospital mortality of D-AKI patients.

Interpretation: In China, D-AKI has caused a substantial medical burden. Chinese pharmacists and nephrologists should bear the major responsibility of leading the campaign of managing D-AKI.

Funding Statement: This study is supported by Medical Policy and Administration Department, National Health and Family Planning Commission of China, 2015. The National Natural Science Foundation of China (No.91742205 and No.81625004), the Beijing Young Scientist Program (BJJWZYJH01201910001006), and Peking University Clinical Scientist Program by the Fundamental Research Funds for the Central Universities.

Declaration of Interests: The authors declare that they have no conflicts of interest.

Ethics Approval Statement: This study was approved by the Ethics Committee of Xuanwu Hospital of Capital Medical University.

Keywords: Drug-induced acute kidney injury

Suggested Citation

Liu, Chen and Yan, Suying and Wang, Jinwei and Fu, Xiujuan and Song, Hongtao and Tong, Rongsheng and Dong, Mei and Ge, Weihong and Wang, Jiawei and Yang, Hui and Wang, Changlian and Xia, Peiyuan and Zhao, Limei and Shen, Sijing and Xie, Juan and Xu, Yangui and Ma, Peizhi and Li, Hongjian and Lu, Shegui and Ding, Yufeng and Jiang, Ling and Lin, Yang and Wang, Maoyi and Qiu, Feng and Feng, Wanyu and Yang, Li, Drug-Induced Acute Kidney Injury in China: A Multicenter Cross-Sectional Survey (April 11, 2019). Available at SSRN: https://ssrn.com/abstract=3487850 or http://dx.doi.org/10.2139/ssrn.3487850

Chen Liu

Capital Medical University

Beijing
China

Suying Yan

Capital Medical University

Beijing
China

Jinwei Wang

Peking University - Renal Division

Beijing
China

Xiujuan Fu

Jilin University (JLU)

Guilin Road
Chaoyang, Changchun 130021
China

Hongtao Song

900 Hospital of the Joint Logistics Team

China

Rongsheng Tong

Sichuan Provincial People's Hospital

Chengdu
China

Mei Dong

Harbin Medical University

157 Baojian Rd
Nangang Qu
Haerbin Shi, Heilongjiang Sheng
China

Weihong Ge

Nanjing University

Nanjing, Jiangsu 210093
China

Jiawei Wang

Beijing Tongren Hospital

Beijing
China

Hui Yang

Affiliated Hospital of Qinghai University

China

Changlian Wang

Fujian Medical University

Fuzhou
China

Peiyuan Xia

Army Medical University

Chongqing, 400038
China

Limei Zhao

China Medical University - Department of Pharmacy

Liaoning, 110004
China

Sijing Shen

Peking University

No. 38 Xueyuan Road
Haidian District
Beijing, Beijing 100871
China

Juan Xie

Guizhou Provincial People's Hospital

China

Yangui Xu

Tianjin First Central Hospital

China

Peizhi Ma

Henan Provincial Peoples Hospital

Zhengzhou, Henan 450003
China

Hongjian Li

Qianfoshan Hospital of Shandong Province

Jinan
China

Shegui Lu

Nanchang University

999 Xuefu Avenue
Hong Gu Tan New District
Nanchang, Jiangxi 330031
China

Yufeng Ding

Huazhong University of Science and Technology (Formerly Tongi Medical University)

1037 Luoyu Rd
Wuhan, Hubei 430074
China

Ling Jiang

Anhui Provincial Hospital

Hefei
China

Yang Lin

Beijing Anzhen Hospital

Beijing
China

Maoyi Wang

Xi'an Jiaotong University (XJTU)

26 Xianning W Rd.
Xi'an Jiao Tong University
Xi'an, Shaanxi 710049
China

Feng Qiu

Chongqing Medical University

China

Wanyu Feng

Peking University

No. 38 Xueyuan Road
Haidian District
Beijing, Beijing 100871
China

Li Yang (Contact Author)

Peking University - Renal Division ( email )

Beijing
China

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