Document Detail


Acute kidney injury and increasing nephrotoxic-medication exposure in noncritically-ill children.
MedLine Citation:
PMID:  21212419     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND OBJECTIVES: Acute kidney injury (AKI) in hospitalized children results in increased patient morbidity and mortality. Nephrotoxic-medication exposure is a common cause of AKI. Currently, no data exist to quantify the risks of developing AKI for various nephrotoxic medications in children. The primary aim of the current study is to assess for a potential association between nephrotoxic medications and the risk of developing AKI in hospitalized noncritically ill children with no pre-existing renal insufficiency. Design, SETTING, PARTICIPANTS, & MEASUREMENTS: We performed a retrospective case-control study in pediatric hospitalized noncritically ill patients aged 1 day to 18 years. The cases were patients who developed AKI, as defined by the pediatric modified RIFLE (pRIFLE) criteria; patients without AKI served as controls and were matched by age category, gender, and disease state.
RESULTS: 561/1660 (33.8%) patients identified for inclusion had AKI (441 category "R," 117 category "I," three category "F"); 357 cases were matched with 357 controls. Patients with AKI had longer length of hospital stay and increased hospital costs. Patients with AKI had exposure to more nephrotoxic medications for a longer period of time compared with controls. Odds of exposure for at least one nephrotoxic medication was significant for development of AKI. Exposure to more nephrotoxic medications was associated with an increased risk of AKI.
CONCLUSIONS: Increasing exposure to three or more nephrotoxic medications places pediatric patients at greater risk of acute kidney injury with resultant increased hospital costs and patient morbidity.
Authors:
Brady S Moffett; Stuart L Goldstein
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Publication Detail:
Type:  Journal Article     Date:  2011-01-06
Journal Detail:
Title:  Clinical journal of the American Society of Nephrology : CJASN     Volume:  6     ISSN:  1555-905X     ISO Abbreviation:  Clin J Am Soc Nephrol     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-04-08     Completed Date:  2011-08-18     Revised Date:  2012-04-02    
Medline Journal Info:
Nlm Unique ID:  101271570     Medline TA:  Clin J Am Soc Nephrol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  856-63     Citation Subset:  IM    
Copyright Information:
© 2011 by the American Society of Nephrology
Affiliation:
Texas Children's Hospital, Department of Pharmacy, 6621 Fannin Street, MC 2-2510, Houston, TX 77030, USA. bsmoffet@texaschildrens.org
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MeSH Terms
Descriptor/Qualifier:
Acute Kidney Injury / chemically induced*
Adolescent
Age Factors
Case-Control Studies
Child
Child, Preschool
Creatinine / blood
Female
Humans
Infant
Infant, Newborn
Kidney / drug effects*
Logistic Models
Male
Retrospective Studies
Chemical
Reg. No./Substance:
60-27-5/Creatinine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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