title: Drug-related acute renal failure in hospitalised patients.
abstract: BACKGROUND
  The information available on the incidence and the characteristics of patients with acute renal failure (ARF) related to drugs is scarce.
  
  
  OBJECTIVE
  To estimate the incidence of drug-related ARF in hospitalised patients and to compare their characteristics with those of patients with ARF due to other causes.
  
  
  METHODS
  We selected a prospective cohort of patients with ARF during hospital admission (July 2010-July 2011). Information on patients' demographics, medical antecedents, ARF risk factors, ARF severity according to the RIFLE classification and hospital drug administration was collected. We analysed the relationship of drugs with the ARF episodes using Spanish Pharmacovigilance System methods and algorithm.
  
  
  RESULTS
  A total of 194 cases had an episode of hospital-acquired ARF. The median age of patients was 72 years [IQR 20]; 60% were men. The ARF incidence during hospitalization was 9.6 per 1,000 admissions. According to the RIFLE classification, a risk of kidney damage or kidney injury was present in 77.8% of cases. In 105 (54.1%) cases, ARF was drug-related; the drugs most frequently involved were diuretics, agents acting on the renin-angiotensin system, immunosuppressants, β-blocking agents, calcium channel blockers, contrast media and non-steroid anti-inflammatory drugs. Patients with drug-related ARF had more multi-morbidity, fewer ARF risk factors and lower mortality.
  
  
  CONCLUSIONS
  Half of ARF episodes during hospitalisation were drug related. Patients with drug-related ARF had higher cardiovascular morbidity than those with ARF related to other causes, but they had a lower frequency of ARF risk factors and mortality.
authors.affiliation: Servicio de Farmacología Clínica, Fundació Institut Català de Farmacologia, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, España.
authors.forename: Lujan
authors.initials: L
authors.lastname: Iavecchia
authors.affiliation: Servicio de Farmacología Clínica, Fundació Institut Català de Farmacologia, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, España.
authors.forename: Gloria
authors.initials: G
authors.lastname: Cereza García
authors.affiliation: Servicio de Farmacología Clínica, Fundació Institut Català de Farmacologia, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, España.
authors.forename: Mònica
authors.initials: M
authors.lastname: Sabaté Gallego
authors.affiliation: Servicio de Farmacología Clínica, Fundació Institut Català de Farmacologia, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, España.
authors.forename: Xavier
authors.initials: X
authors.lastname: Vidal Guitart
authors.affiliation: Servicio de Nefrología, Hospital Universitari Vall d'Hebron, Barcelona, España.
authors.forename: Natalia
authors.initials: N
authors.lastname: Ramos Terrades
authors.affiliation: Servicio de Nefrología, Hospital Universitari Vall d'Hebron, Barcelona, España.
authors.forename: Judith
authors.initials: J
authors.lastname: de la Torre
authors.affiliation: Servicio de Nefrología, Hospital Universitari Vall d'Hebron, Barcelona, España.
authors.forename: Alfons
authors.initials: A
authors.lastname: Segarra Medrano
authors.affiliation: Servicio de Farmacología Clínica, Fundació Institut Català de Farmacologia, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, España. Electronic address: antonia.ficf@gmail.com.
authors.forename: Antònia
authors.initials: A
authors.lastname: Agustí Escasany
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood / Q000139:chemically induced* / Q000453:epidemiology; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D000970:Antineoplastic Agents / Q000009:adverse effects; D002317:Cardiovascular Agents / Q000009:adverse effects; D003287:Contrast Media / Q000009:adverse effects; D003404:Creatinine / Q000097:blood; D004232:Diuretics / Q000009:adverse effects; D005260:Female; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D000970:Antineoplastic Agents; D002317:Cardiovascular Agents; D003287:Contrast Media; D004232:Diuretics; D003404:Creatinine
keywords: Acute renal failure; Drugs; Fármacos; Insuficiencia renal aguda; Medicamentos; Medications