A clinical study of drugs associated with acute kidney injury in the Chinese population
Revised accepted: 29 December 2019
Purpose: To carry out a study aimed at comprehensive identificat6ion of classes of drugs which cause acute kidney injury (AKI). Methods: A total of 110,508 patients enrolled in Weihai Central Hospital, Weihai, Shandong, China between March 2014 to April 2018 were asked to provide information on comprehensive prescription drug coverage including antivirals, antibiotics, NSAIDs, diuretics and anti-cancer drugs.
Only the active users of these classes of drugs were included in the study. Daily prescription dose, duration, date and time of each drug were recorded. Furthermore, the characteristics and other conditions of the patients such as hypertension, congestive heart failure, diabetes, liver disease, angiotensin receptor blockers (ARBs), alpha-receptor blockers, beta-receptor blockers, and calcium channel-blockers were included.
Results: A total of 1230 patients presented with AKI during the first 60 days of follow-up, while 1546 (58 %) patients were diagnosed with AKI in the secondary endpoint.
Indomethacin, valacyclovir, fluorouracil, levofloxacin, ibuprofen and rofecoxib produced higher frequencies of AKI than the control drug, celecoxib.
Indomethacin (OR = 2.97 ; 95 % CI= 1.94 - 3.89) and valacyclovir (OR = 2.85 ; 95 % CI = 1.56 - 3.42) were mostly responsible for AKI, followed by rofecoxib (OR = 2.48 ; 95 % CI = 2.32 - 2.71), fluorouracil (OR = 2.58 ; 95 % CI = 1.94 - 3.11), ibuprofen (OR = 1.68 ; 95 % CI = 1.28 - 2.21) and levofloxacin (OR = 1.58 ; 95 % CI = 1.48 - 2.73), in that order
Conclusion: This study has identified various classes of drugs which frequently induced AKI. Therefore, physicians should exercise caution in prescribing these drugs, and should consider other medicines to minimize the risk of AKI.