Abstract
Objective: The aim of this study was to investigate the incidence, prognosis and risk factors of the prognosis of drug-induced acute kidney injury (AKI) in hospitalized patients in 23 third-level urban hospitals in China.
Methods: All patients hospitalized in January and July 2014 in 23 third-level urban hospitals in China were screened by the Lab Information System. All patients with AKI according to the Kidney Disease Improving Global Outcomes (KDIGO) criteria were screened. The Naranjo criteria were used to evaluate whether AKI was drug induced. Only drug-induced AKI patients were included in the study. All patients were divided into 4 groups according to their locations, including the north, south, northwest and southwest groups. The patient medical records were retrospectively analyzed to determine the incidence, prognosis and risk factors of drug-induced AKI.
Results: In total, 1915 AKI patients in 23 hospitals were screened. Seven hundred thirty-five patients were considered drug-induced AKI patients, of which 477 were males and 258 were females. Four hundred twenty-eight (58.23%) were elderly (≥ 60 years old). The drug-induced AKI incidence rate in all AKI patients was 38.38%, with a mortality rate of 13.88%. The top 5 drugs were furosemide, pantoprazole, vancomycin, contrast (iodine) and mannitol, which cumulatively accounted for 27.02% of all drug-induced AKI cases.
Four risk factors were found for the prognosis of drug-induced AKI, including length of stay (LOS) (P=0.000), highest Scr day (P=0.000), Scr above the upper limit (P=0.015) and hypoalbuminemia (P=0.002).
Conclusion: The incidence of drug-induced AKI is high in hospitalized patients. Diuretics and dehydrates, proton pump inhibitors (PPIs), antimicrobials and contrast media were the most common medication types. Hypoalbuminemia is the only modifiable risk factor for the prognosis of drug-induced AKI.
