Drug-induced acute kidney injury in patients of the Military University Regional Hospital of Constantine

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Introduction. Renal drug toxicity is the most frequent aspect of drug-induced acute kidney injury (Drug-induced AKI). This study aims to determine the incidence of drug induced AKI, and to study the clinical, biological and evolutionary characteristics of adult patients with AKI at Regional Military Hospital of Constantine (RMHC). Methods. this is prospective study, over a period of two years, from January 2017 to December 2018, interesting patients with drug-induced AKI hospitalized or seen at the outpatient clinic at RMHC. Variables were collected in a pre-established data collection form. Data entry and analysis were carried out using SPSS software version 20.0. Results. A total of 104 cases of drug-induced AKI were included in the study out of 636 AKI diagnosed from all causes, an incidence of 16.35%. Mean age was 60.48 ± 16.59 years, with a sex ratio M/F of 1.21. Drugs altering renal autoregulation were responsible for 51% of drug-induced AKI; followed by combinations of several nephrotoxic drugs in 15.4% of cases; chemotherapy products in 11.5%; contrast products in 9.6%; and antibiotics in 5.8%. At 6 months of the AKI episode, 20% of our patients recovered a GFR> 60 ml / min, 55.8% presented a chronic kidney disease (CKD) stage 3, 15.8% CKD stage 4 and 8.4% CKD stage 5. Our study identified some factors of poor prognosis for progression to CKD, such as advanced age, history of diabetes and cancer, significant proteinuria, drug-related factors represented by chemotherapy products, concomitant intravenous and enteral route of administration as well as prolonged exposure to the drug, hypertensive patients under chemotherapy or Drugs altering renal autoregulation, and diabetic under chemotherapy or non steroidal anti-inflammatory drugs (NSAID). Conclusions. Subjects with drug AKI are at risk of developing CKD. Preventive measures should be taken by carefully prescribing the drugs identified in this study.