OBJECTIVE: To evaluate the association between the use of nephrotoxic drugs and acute kidney injury in critically ill pediatric patients. METHODS: This was a retrospective cohort study involving all children admitted to the intensive care unit of a pediatric hospital during a 1-year period. Acute kidney injury was defined according to the KDIGO classification. Patients with a length of hospital stay longer than 48 hours and an age between 1 month and 14 years were included. Patients with acute or chronic nephropathy, uropathy, congenital or acquired heart disease, chronic use of nephrotoxic drugs, rhabdomyolysis and tumor lysis syndrome were excluded. Patients were classified according to the use of nephrotoxic drugs during their stay at the pediatric intensive care unit. RESULTS: The sample consisted of 226 children, of whom 37.1% used nephrotoxic drugs, 42.4% developed acute kidney injury, and 7.5% died. The following drugs, when used alone, were associated with acute kidney injury: acyclovir (p < 0.001), vancomycin (p < 0.001), furosemide (p < 0.001) and ganciclovir (p = 0.008). The concomitant use of two or more nephrotoxic drugs was characterized as an independent marker of renal dysfunction (p < 0.001). After discharge from the pediatric intensive care unit, renal function monitoring in the ward was inadequate in 19.8% of cases. CONCLUSION: It is necessary for intensivist physicians to have knowledge of the main nephrotoxic drugs to predict, reduce or avoid damage to their patients.
OBJECTIVE: To evaluate the association between the use of nephrotoxic drugs and acute kidney injury in critically ill pediatric patients. METHODS: This was a retrospective cohort study involving all children admitted to the intensive care unit of a pediatric hospital during a 1-year period. Acute kidney injury was defined according to the KDIGO classification. Patients with a length of hospital stay longer than 48 hours and an age between 1 month and 14 years were included. Patients with acute or chronic nephropathy, uropathy, congenital or acquired heart disease, chronic use of nephrotoxic drugs, rhabdomyolysis and tumor lysis syndrome were excluded. Patients were classified according to the use of nephrotoxic drugs during their stay at the pediatric intensive care unit. RESULTS: The sample consisted of 226 children, of whom 37.1% used nephrotoxic drugs, 42.4% developed acute kidney injury, and 7.5% died. The following drugs, when used alone, were associated with acute kidney injury: acyclovir (p < 0.001), vancomycin (p < 0.001), furosemide (p < 0.001) and ganciclovir (p = 0.008). The concomitant use of two or more nephrotoxic drugs was characterized as an independent marker of renal dysfunction (p < 0.001). After discharge from the pediatric intensive care unit, renal function monitoring in the ward was inadequate in 19.8% of cases. CONCLUSION: It is necessary for intensivist physicians to have knowledge of the main nephrotoxic drugs to predict, reduce or avoid damage to their patients.
Authors: Suchitra Rao; Mark J Abzug; Phyllis Carosone-Link; Tori Peterson; Jason Child; Georgette Siparksy; Danielle Soranno; Melissa A Cadnapaphornchai; Eric A F Simões Journal: J Pediatr Date: 2015-02-21 Impact factor: 4.406
Authors: Jason M Misurac; Chad A Knoderer; Jeffrey D Leiser; Corina Nailescu; Amy C Wilson; Sharon P Andreoli Journal: J Pediatr Date: 2013-01-26 Impact factor: 4.406
Authors: Daniela Ponce; Caroline de Pietro Franco Zorzenon; Nara Yamane Dos Santos; Ubirajara Aparecido Teixeira; André Luís Balbi Journal: Rev Bras Ter Intensiva Date: 2011-09
Authors: Talita Machado Levi; Sérgio Pinto de Souza; Janine Garcia de Magalhães; Márcia Sampaio de Carvalho; André Luiz Barreto Cunha; João Gabriel Athayde de Oliveira Dantas; Marília Galvão Cruz; Yasmin Laryssa Moura Guimarães; Constança Margarida Sampaio Cruz Journal: Rev Bras Ter Intensiva Date: 2013 Oct-Dec