title: Phenotype standardization for drug-induced kidney disease.
abstract: Drug-induced kidney disease is a frequent cause of renal dysfunction; however, there are no standards to identify and characterize the spectrum of these disorders. We convened a panel of international, adult and pediatric, nephrologists and pharmacists to develop standardized phenotypes for drug-induced kidney disease as part of the phenotype standardization project initiated by the International Serious Adverse Events Consortium. We propose four phenotypes of drug-induced kidney disease based on clinical presentation: acute kidney injury, glomerular, tubular, and nephrolithiasis, along with the primary and secondary clinical criteria to support the phenotype definition, and a time course based on the KDIGO/AKIN definitions of acute kidney injury, acute kidney disease, and chronic kidney disease. Establishing causality in drug-induced kidney disease is challenging and requires knowledge of the biological plausibility for the specific drug, mechanism of injury, time course, and assessment of competing risk factors. These phenotypes provide a consistent framework for clinicians, investigators, industry, and regulatory agencies to evaluate drug nephrotoxicity across various settings. We believe that this is the first step to recognizing drug-induced kidney disease and developing strategies to prevent and manage this condition.
authors: University of California San Diego School of Medicine, La Jolla, California, USA.
authors: Ravindra L
authors: RL
authors: Mehta
authors: University of California San Diego Skaggs School of Pharmacy, La Jolla, California, USA.
authors: Linda
authors: L
authors: Awdishu
authors: Royal Free Hospital and University College Medical School, UCL Centre for Nephrology, London, UK.
authors: Andrew
authors: A
authors: Davenport
authors: University College Dublin School of Medicine and Medical Science, Health Sciences Centre, Belfield, Dublin, Ireland.
authors: Patrick T
authors: PT
authors: Murray
authors: University of São Paolo, São Paolo, Brazil.
authors: Etienne
authors: E
authors: Macedo
authors: Albany Medical College, Albany, New York, USA.
authors: Jorge
authors: J
authors: Cerda
authors: Care Hospitals, Hyderabad, Telangana, India.
authors: Raj
authors: R
authors: Chakaravarthi
authors: International Serious Adverse Event Consortium, Chicago, Illinois, USA.
authors: Arthur L
authors: AL
authors: Holden
authors: Division of Nephrology and Hypertension at Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
authors: Stuart L
authors: SL
authors: Goldstein
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood / Q000139:chemically induced* / Q000473:pathology; D001639:Bicarbonates / Q000097:blood; D001706:Biopsy; D032921:Consensus; D003404:Creatinine / Q000097:blood / Q000652:urine; D003697:Delphi Technique; D004573:Electrolytes / Q000097:blood; D006029:Glycosuria / Q000139:chemically induced; D006417:Hematuria / Q000139:chemically induced; D006801:Humans; D007678:Kidney Glomerulus / Q000187:drug effects / Q000473:pathology* / Q000503:physiopathology; D007684:Kidney Tubules / Q000187:drug effects / Q000473:pathology* / Q000503:physiopathology; D008274:Magnesium / Q000652:urine; D009336:Necrosis / Q000139:chemically induced; D009395:Nephritis, Interstitial / Q000139:chemically induced; D053040:Nephrolithiasis / Q000139:chemically induced*; D010641:Phenotype; D010710:Phosphates / Q000652:urine; D011188:Potassium / Q000652:urine; D011507:Proteinuria / Q000139:chemically induced; D013997:Time Factors
chemical_list: D001639:Bicarbonates; D004573:Electrolytes; D010710:Phosphates; D003404:Creatinine; D008274:Magnesium; D011188:Potassium