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Drugs as risk factors of acute kidney injury in critically ill children

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Abstract

Background

Acute kidney injury (AKI) is a serious condition in critically ill children. Nephrotoxic medication exposure is a common contributing factor to AKI, but little literature is available in pediatrics. The aim of the present study was to assess potential associations between drugs and the risk of developing AKI.

Methods

We performed a retrospective case-control study in a pediatric intensive care unit (PICU). Cases were patients who developed AKI during PICU stay. Patients without AKI served as controls and were matched to cases by age and gender in a one-to-one ratio.

Results

One hundred case-control pairs were included. Cases were not statistically different from controls with regard to median weight and main diagnoses, but differed with regard to the need for mechanical ventilation, severity of illness, and median length of PICU stay. Multivariate models revealed a statistically significant higher risk of developing AKI for patients treated with metamizole, morphine, paracetamol, and tropisetron. A similar risk could be shown for medication groups, namely glucocorticoids, betalactam antibiotics, opioids, and non-steroidal anti-inflammatory drugs.

Conclusions

The results suggest that drugs are associated with acute renal dysfunction in critically ill children, but the multifactorial causes of AKI should be kept in mind.

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Ethical disclosure

This study has been approved by the local Ethics Committee. The Institutional Review Board approved the study protocol and waived the need for informed written patient consent.

Conflict of interest

The authors declare no conflicts of interest.

Author information

Authors and Affiliations

  1. Hospital Pharmacy, University Children’s Hospital Zürich, Steinwiesstrasse 75, 8032, Zürich, Switzerland

    Corina Glanzmann & Priska Vonbach

  2. Department of Intensive Care and Neonatology, University Children’s Hospital Zürich, Steinwiesstrasse 75, 8032, Zürich, Switzerland

    Bernhard Frey

  3. Hospital Pharmacy, University Hospital Basel, Spitalstrasse 26, 4031, Basel, Switzerland

    Christoph R. Meier

  4. Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland

    Christoph R. Meier

Authors
  1. Corina Glanzmann
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  2. Bernhard Frey
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  3. Priska Vonbach
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  4. Christoph R. Meier
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Corresponding author

Correspondence to Corina Glanzmann.

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Glanzmann, C., Frey, B., Vonbach, P. et al. Drugs as risk factors of acute kidney injury in critically ill children. Pediatr Nephrol 31, 145–151 (2016). https://doi.org/10.1007/s00467-015-3180-9

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  • DOI: https://doi.org/10.1007/s00467-015-3180-9

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