Abstract
Context Drug-induced liver and kidney injuries are the most common adverse drug reactions in the clinic, and they have similar pathogeneses. Aims To analyze the clinical characteristics of patients with drug-induced liver and/or kidney injury. Settings and Design This was a retrospective study. Methods and Materials We analyzed data from 162 patients with drug-induced liver and/or kidney injury from 2008 to 2018 at the Chinese Rocket Force Characteristic Medical Center. Univariate and multivariate logistic analyses were performed on the drugs used, sex, age, weight, complications, and laboratory test results. Statistical analysis was performed using SPSS 25.0 statistical software. Results (1) The most common drugs causing organ injury in this study were antineoplastic drugs, antibiotics, traditional Chinese medicine, lipid-lowering drugs, and nonsteroidal anti-inflammatory drugs. (2) Among 22 patients with drug-induced liver and kidney injuries, 68.18% had a hepatocellular pattern, 13.64% had a mixed pattern, and 18.18% had a cholestatic pattern. Among the three groups, the P value for creatinine was 0.002. (3) The P value for urinary protein between the isolated kidney injury group and the liver and kidney injury group was 0.028. (4) Multivariate analysis showed that, among the drug-induced renal injury patients and all injury patients, those with a higher neutrophil percentage had a lower risk of liver injury (OR = 0.574, 95% CI: 0.390–0.846; OR = 0.545, 95% CI: 0.396–0.749). Conclusions (1) The serum creatinine level was higher in liver injury patients with the cholestatic pattern than in those with the hepatocellular or mixed pattern. (2) There was a significant difference in urinary protein between the isolated kidney and the liver and kidney injury groups. (3) Among patients with drug-induced organ injury, those with a higher neutrophils percentage had a lower risk of liver injury.
Highlights
We studied the data of 162 patients with acute druginduced liver and/or kidney injury to determine their drug use, the differences in liver and kidney injuries caused by the same drug, the characteristics of liver and kidney injuries caused by different drugs, and risk factors for liver and kidney injuries
Student’s t test (T test) was used for comparisons between two groups, and analysis of variance was used for comparisons among three groups. e nonnormally distributed data are expressed as the medians and interquartile ranges. e Mann-Whitney U test (U test) was used for comparisons between two groups, and the rank-sum test was used for comparisons among three groups. e count data are expressed as percentages. e comparisons between two groups were performed with the chi square test
Drug-induced liver or kidney injury is a type of damage to the liver or kidney caused by drugs or metabolites via direct toxicity or the induction of an immune response when the drug is metabolized, decomposed, or excreted through the liver and kidney
Summary
1. Introduction e human liver is closely related to the kidney. In traditional Chinese medicine, there is the saying that the “liver and kidney have the same origin.”. In Western medicine, there is the concept of a “hepatorenal disorder (HRD)” [1]. E liver and kidney are important organs for drug metabolism and excretion. The problem of clinical drug-induced liver and kidney injuries has become more prominent. We studied the data of 162 patients with acute druginduced liver and/or kidney injury to determine their drug use, the differences in liver and kidney injuries caused by the same drug, the characteristics of liver and kidney injuries caused by different drugs, and risk factors for liver and kidney injuries. Our study may provide guidelines for rational drug use in the clinic
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