Hanna K Welch1, John A Kellum2, Sandra L Kane-Gill1,3. 1. Department of Pharmacy and Therapeutics, University of Pittsburgh School of Pharmacy, Pittsburgh, Pennsylvania. 2. Center for Critical Care Nephrology, The CRISMA (Clinical Research, Investigation, and Systems Modeling of Acute Illness) Center, Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania. 3. Department of Critical Care Medicine, Biomedical Informatics, and Clinical Translational Science Institute, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
Abstract
STUDY OBJECTIVE: Acute kidney injury (AKI) is a common condition associated with both short-term and long-term consequences including dialysis, chronic kidney disease, and mortality. Although the United States Food and Drug Administration Adverse Event Reporting System (FAERS) database is a powerful tool to examine drug-associated events, to our knowledge, no study has analyzed this database to identify the most common drugs reported with AKI. The objective of this study was to analyze AKI reports and associated medications in the FAERS database. DESIGN: Retrospective pharmacovigilance disproportionality analysis. DATA SOURCE: Food and Drug Administration Adverse Event Reporting System database. MEASUREMENTS AND MAIN RESULTS: We queried the FAERS database for reports of AKI from 2004 quarter 1 through 2015 quarter 3. Extracted drugs were assessed using published references and categorized as known, possible, or new potential nephrotoxins. The reporting odds ratio (ROR), a measure of reporting disproportionality, was calculated for the 20 most frequently reported drugs in each category. We retrieved 7,241,385 adverse event reports, of which 193,996 (2.7%) included a report of AKI. Of the AKI reports, 16.5% were known nephrotoxins, 18.6% were possible nephrotoxins, and 64.8% were new potential nephrotoxins. Among the most commonly reported drugs, those with the highest AKI ROR were aprotinin (7614 reports; ROR 115.70, 95% confidence interval [CI] 110.63-121.01), sodium phosphate (1687 reports; ROR 55.81, 95% CI 51.78-60.17), furosemide (1743 reports; ROR 12.61, 95% CI 11.94-13.32), vancomycin (1270 reports, ROR 12.19, 95% CI 11.45-12.99), and metformin (4701 reports; ROR 10.65, 95% CI 10.31-11.00). The combined RORs for the 20 most frequently reported drugs with each nephrotoxin classification were 3.71 (95% CI 3.66-3.76) for known nephrotoxins, 2.09 (95% CI 2.06-2.12) for possible nephrotoxins, and 1.55 (95% CI 1.53-1.57) for new potential nephrotoxins. CONCLUSION: Acute kidney injury was a common reason for adverse event reporting in the FAERS. Most AKI reports were generated for medications not recognized as nephrotoxic according to our classification system. This report provides data on medications needing further research to determine the risk of AKI with these new potential nephrotoxins.
STUDY OBJECTIVE:Acute kidney injury (AKI) is a common condition associated with both short-term and long-term consequences including dialysis, chronic kidney disease, and mortality. Although the United States Food and Drug Administration Adverse Event Reporting System (FAERS) database is a powerful tool to examine drug-associated events, to our knowledge, no study has analyzed this database to identify the most common drugs reported with AKI. The objective of this study was to analyze AKI reports and associated medications in the FAERS database. DESIGN: Retrospective pharmacovigilance disproportionality analysis. DATA SOURCE: Food and Drug Administration Adverse Event Reporting System database. MEASUREMENTS AND MAIN RESULTS: We queried the FAERS database for reports of AKI from 2004 quarter 1 through 2015 quarter 3. Extracted drugs were assessed using published references and categorized as known, possible, or new potential nephrotoxins. The reporting odds ratio (ROR), a measure of reporting disproportionality, was calculated for the 20 most frequently reported drugs in each category. We retrieved 7,241,385 adverse event reports, of which 193,996 (2.7%) included a report of AKI. Of the AKI reports, 16.5% were known nephrotoxins, 18.6% were possible nephrotoxins, and 64.8% were new potential nephrotoxins. Among the most commonly reported drugs, those with the highest AKI ROR were aprotinin (7614 reports; ROR 115.70, 95% confidence interval [CI] 110.63-121.01), sodium phosphate (1687 reports; ROR 55.81, 95% CI 51.78-60.17), furosemide (1743 reports; ROR 12.61, 95% CI 11.94-13.32), vancomycin (1270 reports, ROR 12.19, 95% CI 11.45-12.99), and metformin (4701 reports; ROR 10.65, 95% CI 10.31-11.00). The combined RORs for the 20 most frequently reported drugs with each nephrotoxin classification were 3.71 (95% CI 3.66-3.76) for known nephrotoxins, 2.09 (95% CI 2.06-2.12) for possible nephrotoxins, and 1.55 (95% CI 1.53-1.57) for new potential nephrotoxins. CONCLUSION:Acute kidney injury was a common reason for adverse event reporting in the FAERS. Most AKI reports were generated for medications not recognized as nephrotoxic according to our classification system. This report provides data on medications needing further research to determine the risk of AKI with these new potential nephrotoxins.
Authors: Philip Andreas Schytz; Anders Bonde Nissen; Kristine Hommel; Morten Schou; Karl Emil Nelveg-Kristensen; Christian Torp-Pedersen; Gunnar H Gislason; Thomas A Gerds; Nicholas Carlson Journal: J Nephrol Date: 2020-10-01 Impact factor: 3.902
Authors: Mitra K Nadim; Lui G Forni; Ravindra L Mehta; Michael J Connor; Kathleen D Liu; Marlies Ostermann; Thomas Rimmelé; Alexander Zarbock; Samira Bell; Azra Bihorac; Vincenzo Cantaluppi; Eric Hoste; Faeq Husain-Syed; Michael J Germain; Stuart L Goldstein; Shruti Gupta; Michael Joannidis; Kianoush Kashani; Jay L Koyner; Matthieu Legrand; Nuttha Lumlertgul; Sumit Mohan; Neesh Pannu; Zhiyong Peng; Xose L Perez-Fernandez; Peter Pickkers; John Prowle; Thiago Reis; Nattachai Srisawat; Ashita Tolwani; Anitha Vijayan; Gianluca Villa; Li Yang; Claudio Ronco; John A Kellum Journal: Nat Rev Nephrol Date: 2020-10-15 Impact factor: 28.314