[Acute renal insufficiency caused by drugs or iodinated contrast media. Results of a prospective and multicenter study in south Tunisia].
In order to determine the frequency of acute renal failure (ARF) induced by drugs, to identify the agents responsible for it and to define its semiological characteristics, a prospective study was carried out between 1 October 1987 and 30 September 1988, in Sfax and southern Tunisia. Three Departments of Medicine and one Hemodialysis Center participated in this study. Twelve cases of drug-induced ARF were identified among the 73 cases of ARF reported, i.e., a frequency of 16%. Anti-inflammatory non-steroidal drugs (AINS) were implicated in 5 cases and antibiotics in 2. Symptoms of hypersensitivity were observed in 4 patients, 2/3 without oliguria. Renal insufficiency was usually marked: plasma creatinine was 523 +/- 425 mumol/l; proteinuria greater than 1 g/24 h was seen in 2 patients. Hypovolemia and/or hypotension (6 cases) and diabetes mellitus (4 patients) were found to favor ARF. Renal function returned to normal in 9 patients, whereas mild renal failure persisted in the remaining 3 patients. Drug-induced ARF occurs often. AINS are the most frequently incriminated agents and hypersensitivity symptoms without oliguria are the most common manifestations. Drug-induced ARF can be prevented by close monitoring of high-risk patients, i.e., those taking AINS.
Service de Médecine Interne et de Néphrologie, CHU Hédi Chaker, Sfax, Tunisie.
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J
Hachicha
A
A
Bellaj
F
F
Kriaa
M
M
Ayed
E
E
Nasri
A
A
Jarraya
D058186:Acute Kidney Injury / Q000139:chemically induced*; D000368:Aged; D000900:Anti-Bacterial Agents / Q000009:adverse effects; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D003287:Contrast Media / Q000009:adverse effects; D004231:Diuresis; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D006801:Humans; D007455:Iodine / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D011446:Prospective Studies; D014416:Tunisia
D000900:Anti-Bacterial Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D003287:Contrast Media; D007455:Iodine
Les insuffisances rénales aiguës secondaires à des médicaments ou à des produits de contraste iodés. Résultats d'une étude prospective et multicentrique dans le Sud Tunisien.