title: Prescription medications and their influence on acute kidney injury presentation and outcomes.
abstract: BACKGROUND
  Acute kidney injury (AKI) is a common clinical problem. An increase in the severity of AKI is associated with increased mortality and worse prognosis. Many patients presenting with AKI also take long-term medications that may potentially exacerbate or precipitate AKI. However, no study has examined the role of such medications on AKI outcomes.
  
  
  OBJECTIVE
  Our aim was to analyse use of chronic prescription medications by patients presenting with AKI and their impact on outcomes.
  
  
  METHODS
  A retrospective study of discharge data identified 172 patients admitted to a tertiary level metropolitan hospital with a primary diagnosis of AKI over a 2-year period. Patient characteristics, medications that could precipitate or exacerbate AKI, and outcomes based on mortality, need for renal replacement therapy (RRT) and intensive care unit admission were analysed.
  
  
  RESULTS
  Patients taking medications (69.2%) were older (P = 0.04) with more comorbidities such as: congestive cardiac failure (P < 0.001), chronic kidney disease (P < 0.001) and diabetes (P = 0.004) than patients not consuming any. Patients taking medications were less likely to be admitted with severe AKI (P = 0.01) or require RRT (P = 0.04). Multivariate logistic regression analysis did not show a significant impact of medications on outcomes.
  
  
  CONCLUSIONS
  Prescription medication use in patients presenting with AKI is common. Despite being used in older patients with more comorbidities, these medications had no detrimental effect on need for RRT, intensive care unit admission or mortality, and were associated with a decrease in the incidence of severe AKI.
authors.affiliation: Renal Unit, Liverpool Hospital, Australia.
authors.forename: H
authors.initials: H
authors.lastname: Cheikh Hassan
authors.forename: A
authors.initials: A
authors.lastname: Makris
authors.forename: M G
authors.initials: MG
authors.lastname: Suranyi
authors.forename: J K W
authors.initials: JK
authors.lastname: Wong
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality*; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D055553:Prescription Drugs / Q000627:therapeutic use*; D012189:Retrospective Studies; D062606:Tertiary Care Centers / Q000639:trends*; D016896:Treatment Outcome
chemical_list: D055553:Prescription Drugs