Drug-Induced Acute Kidney Injury: A Study from the French Medical Administrative and the French National Pharmacovigilance Databases Using Capture-Recapture Method.

Anne-Lise Rolland,Guillaume Drablier,Anne-Sophie Garnier,Marie Briet,Katy Meunier

doi:10.3390/jcm10020168

Anne-Lise Rolland, Guillaume Drablier + Show 3 more

Open Access

https://doi.org/10.3390/jcm10020168

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Abstract

Background: Acute kidney injury (AKI) is a public health concern. Among the pathological situations leading to AKI, drugs are preventable factors but are still under-notified. We aimed to provide an overview of drug-induced AKI (DIAKI) using pharmacovigilance and medical administrative databases Methods: A query of the PMSI database (French Medical Information System Program) of adult inpatient hospital stays between 1 January 2017 and 31 December 2018 was performed using ICD-10 (International Classification of Diseases 10th revision) codes to identify AKI cases which were reviewed by a nephrologist and a pharmacovigilance expert to identify DIAKI cases. In parallel, DIAKIs notified in the French Pharmacovigilance Database (FPVDB) were collected. A capture-recapture method was performed to estimate the total number of DIAKIs. Results: The estimated total number of DIAKIs was 521 (95%CI 480; 563), representing 20.0% of all AKIs. The notification was at a rate of 12.9% (95%CI 10.0; 15.8). According to the KDIGO classification, 50.2% of the DIAKI cases were stage 1 and 49.8% stage 2 and 3. The mortality rate was 11.1% and 9.6% required hemodialysis. Conclusion: This study showed that drugs are involved in a significant proportion of patients developing AKI during a hospital stay and emphasizes the severity of DIAKI cases.

Highlights

Acute kidney injury (AKI) is an increasing health burden worldwide in terms of morbidity, mortality, and economic impact [1]
Three thousand seven hundred and fifteen hospital stay with AKI were extracted from the PMSI database
AKI resulting from an adverse drug effect (ADR) was found in 460 stays (20%) (Figure S1)

Summary

Introduction

Acute kidney injury (AKI) is an increasing health burden worldwide in terms of morbidity, mortality, and economic impact [1]. The hospital incidence rate for AKI in adults is 22% and the pooled AKI-associated mortality rates are 24% according to the international meta-analysis performed by Susantitaphong et al [2]. AKI is an increasingly recognized risk factor for chronic kidney disease (CKD) and end-stage renal disease [3,4]. Many types of pathological situations may cause AKI including sepsis, critical illness, circulatory shock, radiocontrast agents, and nephrotoxic drugs. Exposure to nephrotoxic drugs or radiocontrast agents are preventable factors [5,6]. A deeper understanding will allow us to prevent the risk of drug-induced acute kidney injury (DIAKI)

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