Clinical Characteristics and Outcomes of Drug-Induced Acute Kidney Injury Cases

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dc.coverageDOI: 10.1016/j.ekir.2023.07.037
dc.creatorYousif, Zaid K.
dc.creatorKoola, Jejo D.
dc.creatorMacedo, Etienne
dc.creatorCerda, Jorge
dc.creatorGoldstein, Stuart L.
dc.creatorChakravarthi, Rajasekara
dc.creatorLewington, Andrew
dc.creatorSelewski, David
dc.creatorZappitelli, Michael
dc.creatorCruz, Dinna
dc.creatorTolwani, Ashita
dc.creatorJoy, Melanie S.
dc.creatorJha, Vivekanand
dc.creatorRamachandran, Raja
dc.creatorOstermann, Marlies
dc.creatorPandya, Bhavna
dc.creatorAcharya, Anjali
dc.creatorBrophy, Patrick
dc.creatorPonce, Daniela
dc.creatorSteinke, Julia
dc.creatorBouchard, Josee
dc.creatorIrarrazabal, Carlos E.
dc.creatorIrarrazabal, Romina
dc.creatorBoltansky, Andrés
dc.creatorAskenazi, David
dc.creatorKolhe, Nitin
dc.creatorClaure-Del Granado, Rolando
dc.creatorBenador, Nadine
dc.creatorCastledine, Clare
dc.creatorDavenport, Andrew
dc.creatorBarratt, Jonathan
dc.creatorBhandari, Sunil
dc.creatorRiley, Alyssa A.
dc.creatorDavis, T. K.
dc.creatorFarmer, Christopher
dc.creatorHogarth, Michael
dc.creatorThomas, Mark
dc.creatorMurray, Patrick T.
dc.creatorRobinson-Cohen, Cassianne
dc.creatorNicoletti, Paola
dc.creatorVaingankar, Sucheta
dc.creatorMehta, Ravindra
dc.creatorAwdishu, Linda
dc.date2023
dc.date.accessioned2025-11-18T19:55:03Z
dc.date.available2025-11-18T19:55:03Z
dc.description<p>Introduction: Drug-induced acute kidney injury (DI-AKI) is a frequent adverse event. The identification of DI-AKI is challenged by competing etiologies, clinical heterogeneity among patients, and a lack of accurate diagnostic tools. Our research aims to describe the clinical characteristics and predictive variables of DI-AKI. Methods: We analyzed data from the Drug-Induced Renal Injury Consortium (DIRECT) study (NCT02159209), an international, multicenter, observational cohort study of enriched clinically adjudicated DI-AKI cases. Cases met the primary inclusion criteria if the patient was exposed to at least 1 nephrotoxic drug for a minimum of 24 hours prior to AKI onset. Cases were clinically adjudicated, and inter-rater reliability (IRR) was measured using Krippendorff's alpha. Variables associated with DI-AKI were identified using L1 regularized multivariable logistic regression. Model performance was assessed using the area under the receiver operating characteristic curve (ROC AUC). Results: A total of 314 AKI cases met the eligibility criteria for this analysis, and 271 (86%) cases were adjudicated as DI-AKI. The majority of the AKI cases were recruited from the United States (68%). The most frequent causal nephrotoxic drugs were vancomycin (48.7%), nonsteroidal antiinflammatory drugs (18.2%), and piperacillin/tazobactam (17.8%). The IRR for DI-AKI adjudication was 0.309. The multivariable model identified age, vascular capacity, hyperglycemia, infections, pyuria, serum creatinine (SCr) trends, and contrast media as significant predictors of DI-AKI with good performance (ROC AUC 0.86). Conclusion: The identification of DI-AKI is challenging even with comprehensive adjudication by experienced nephrologists. Our analysis identified key clinical characteristics and outcomes of DI-AKI compared to other AKI etiologies.</p>eng
dc.identifierhttps://investigadores.uandes.cl/en/publications/b52ae88c-429e-4118-abb3-b1ca9055deed
dc.identifier.urihttps://repositorio.uandes.cl/handle/uandes/59067
dc.languageeng
dc.rightsinfo:eu-repo/semantics/openAccess
dc.sourcevol.8 (2023) nr.11 p.2333-2344
dc.subjectdrug-induced acute kidney injury
dc.subjectnephrotoxicity
dc.titleClinical Characteristics and Outcomes of Drug-Induced Acute Kidney Injury Caseseng
dc.typeArticleeng
dc.typeArtículospa
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