Drug-induced acute kidney injury in the critically ill adult: recognition and prevention strategies.
Acute kidney injury is common in critically ill patients, with an incidence of 20% to 30%. It has been associated with increased mortality, hospital length of stay, and total cost. A number of strategies may be beneficial in identifying at-risk patients. In addition, using preventive measures and avoiding nephrotoxic medications are paramount in reducing the overall incidence. Although multifactorial, drug-induced acute kidney injury may account for up to 25% of all cases of acute kidney injury in this population. This review focuses on the mechanisms of drug-induced acute kidney injury in critically ill adults and offers preventive strategies when appropriate.
Bentley
Michael L
ML
Department of Pharmacy Services, Carilion Clinic, Roanoke Memorial Hospital, Roanoke, VA, USA. mlbentley@carilionclinic.org
Corwin
Howard L
HL
Dasta
Joseph
J
D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000175:diagnosis / Q000517:prevention & control*; D000328:Adult; D000617:Aminoglycosides / Q000009:adverse effects; D000666:Amphotericin B / Q000009:adverse effects; D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D000935:Antifungal Agents / Q000009:adverse effects; D065095:Calcineurin Inhibitors; D003287:Contrast Media / Q000009:adverse effects; D003422:Critical Care / Q000379:methods*; D016638:Critical Illness; D016861:Cyclooxygenase Inhibitors / Q000009:adverse effects; D020000:Decision Support Systems, Clinical; D064420:Drug-Related Side Effects and Adverse Reactions / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D050316:Medical Order Entry Systems
D000617:Aminoglycosides; D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000935:Antifungal Agents; D065095:Calcineurin Inhibitors; D003287:Contrast Media; D016861:Cyclooxygenase Inhibitors; D000666:Amphotericin B