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Drugs as risk factors of acute kidney injury in critically ill children


Glanzmann, Corina; Frey, Bernhard; Vonbach, Priska; Meier, Christoph R (2016). Drugs as risk factors of acute kidney injury in critically ill children. Pediatric Nephrology, 31(1):145-151.

Abstract

BACKGROUND: Acute kidney injury (AKI) is a serious condition in critically ill children. Nephrotoxic medication exposure is a common contributing factor to AKI, but little literature is available in pediatrics. The aim of the present study was to assess potential associations between drugs and the risk of developing AKI.
METHODS: We performed a retrospective case-control study in a pediatric intensive care unit (PICU). Cases were patients who developed AKI during PICU stay. Patients without AKI served as controls and were matched to cases by age and gender in a one-to-one ratio.
RESULTS: One hundred case-control pairs were included. Cases were not statistically different from controls with regard to median weight and main diagnoses, but differed with regard to the need for mechanical ventilation, severity of illness, and median length of PICU stay. Multivariate models revealed a statistically significant higher risk of developing AKI for patients treated with metamizole, morphine, paracetamol, and tropisetron. A similar risk could be shown for medication groups, namely glucocorticoids, betalactam antibiotics, opioids, and non-steroidal anti-inflammatory drugs.
CONCLUSIONS: The results suggest that drugs are associated with acute renal dysfunction in critically ill children, but the multifactorial causes of AKI should be kept in mind.

Abstract

BACKGROUND: Acute kidney injury (AKI) is a serious condition in critically ill children. Nephrotoxic medication exposure is a common contributing factor to AKI, but little literature is available in pediatrics. The aim of the present study was to assess potential associations between drugs and the risk of developing AKI.
METHODS: We performed a retrospective case-control study in a pediatric intensive care unit (PICU). Cases were patients who developed AKI during PICU stay. Patients without AKI served as controls and were matched to cases by age and gender in a one-to-one ratio.
RESULTS: One hundred case-control pairs were included. Cases were not statistically different from controls with regard to median weight and main diagnoses, but differed with regard to the need for mechanical ventilation, severity of illness, and median length of PICU stay. Multivariate models revealed a statistically significant higher risk of developing AKI for patients treated with metamizole, morphine, paracetamol, and tropisetron. A similar risk could be shown for medication groups, namely glucocorticoids, betalactam antibiotics, opioids, and non-steroidal anti-inflammatory drugs.
CONCLUSIONS: The results suggest that drugs are associated with acute renal dysfunction in critically ill children, but the multifactorial causes of AKI should be kept in mind.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Children's Hospital Zurich > Medical Clinic
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:January 2016
Deposited On:16 Feb 2017 09:33
Last Modified:19 Feb 2017 07:53
Publisher:Springer
ISSN:0931-041X
Publisher DOI:https://doi.org/10.1007/s00467-015-3180-9
PubMed ID:26260379

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