Drug therapy and other factors associated with the development of acute kidney injury in critically ill patients: a cross-sectional study
| Autor(a) principal: | |
|---|---|
| Data de Publicação: | 2018 |
| Outros Autores: | , , , , |
| Tipo de documento: | Artigo |
| Idioma: | eng |
| Título da fonte: | Repositório Institucional da FIOCRUZ (ARCA) |
| DOI: | 10.7717/peerj.5405. eCollection 2018 |
| Texto Completo: | https://www.arca.fiocruz.br/handle/icict/32947 |
Resumo: | Universidade Federal de Minas Gerais. Faculdade de Farmácia. Belo Horizonte, MG, Brazil. |
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Soares, Danielly BotelhoMambrini, Juliana Vaz de MeloBotelho, Gabriela RebouçasGirundi, Flávia FialhoBotoni, Fernando AntonioMartins, Maria Auxiliadora Parreiras2019-05-06T13:57:21Z2019-05-06T13:57:21Z2018SOARES, Danielly Botelho et al. Drug therapy and other factors associated with the development of acute kidney injury in critically ill patients: a cross-sectional study. PeerJ, v. 6, p. 1-19, 2018.2167-8359https://www.arca.fiocruz.br/handle/icict/3294710.7717/peerj.5405. eCollection 2018engPeerJ Inc.Prática clinicaCuidados intensivosUtilização de drogasInflamação dos nefronsFalência renalClinical practiceCritical careDrug utilizationNephrotoxicityRenal failureDrug therapy and other factors associated with the development of acute kidney injury in critically ill patients: a cross-sectional studyinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleUniversidade Federal de Minas Gerais. Faculdade de Farmácia. Belo Horizonte, MG, Brazil.Fundação Oswaldo Cruz. Instituto René Rachou. Belo Horizonte, MG, Brazil.Universidade Federal de Minas Gerais. Faculdade de Farmácia. Belo Horizonte, MG, Brazil.Universidade Federal de Minas Gerais. Faculdade de Farmácia. Belo Horizonte, MG, Brazil.Universidade Federal de Minas Gerais. Faculdade de Medicina. Belo Horizonte, MG, Brazil/Hospital Risoleta Tolentino Neves. Belo Horizonte, MG, Brazil.Universidade Federal de Minas Gerais. Faculdade de Farmácia. Belo Horizonte, MG, Brazil / Universidade Federal de Minas Gerais. Faculdade de Medicina. Belo Horizonte, MG, Brazil / Hospital Risoleta Tolentino Neves. Belo Horizonte, MG, Brazil.Background: Acute kidney injury (AKI) is associated with a significant increase in morbidity, mortality, and health care costs. In intensive care units (ICU), AKI is commonly multifactorial and frequently involves diverse factors, such as hypovolemia, sepsis, and the use of nephrotoxic drugs. We aimed to investigate drug therapy and other factors associated with the development of AKI in a Brazilian public hospital. Methods: This is a cross-sectional study involving critically ill patients at an ICU of a tertiary hospital. All data on sequential serum creatinine (SCr) level, glomerular filtration rate (GFR), and urine output were collected during ICU stay. The primary outcome was the occurrence of AKI assessed by the Acute Kidney Injury Network (AKIN) criterion. Sociodemographics, clinical data and drug therapy were considered as covariates. Factors associated with AKI were assessed using logistic regression. Results: Overall, 122 participants were included in the study. Median age was 46.0 (interquartile range, IQ = 29.0-69.0) years, with a predominance of men (58.2%). Mean number of prescribed drugs throughout ICU stay was 22.0 ± 9.4. The number of potentially nephrotoxic drugs ranged from two to 24 per patient. A total of 29 (23.8%) ICU patients developed AKI. In the AKI-group, patients were older and showed higher Acute Physiology and Chronic Health Evaluation II (APACHE II) scores at admission, higher rates of sedation, mechanical ventilation, and infection. More drugs in general and specifically more vasoactive drugs were prescribed for AKI group. Patients who developed AKI tended to have extended stays in the ICU and a lower probability of being discharged alive than patients with no AKI development. Model adjustments of logistic regression showed that the number of medications (OR 1.15; 95% CI [1.05-1.27]) was the only factor associated with AKI in this study. This association was independent of drug nephrotoxicity. Discussion: Intensive care is characterized by its complexity that combines unstable patients, severe diseases, high density of medical interventions, and drug use. We found that typical risk factors for AKI showed statistical association on bivariate analysis. The contribution of drug therapy in the occurrence of AKI in medical ICUs reinforces the need for prevention strategies focused on early recognition of renal dysfunction and interventions in drug therapy. These actions would help improve the quality of patient care and ensure progress towards medication safety.info:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZLICENSElicense.txtlicense.txttext/plain; charset=utf-83082https://www.arca.fiocruz.br/bitstream/icict/32947/1/license.txt9193a7c197bc67acd023525e72a03240MD51ORIGINALDrug therapy and other factors associated.pdfDrug therapy and other factors associated.pdfapplication/pdf5907525https://www.arca.fiocruz.br/bitstream/icict/32947/2/Drug%20therapy%20and%20other%20factors%20associated.pdf8f14238e97a85aff2912b9b951fcc90fMD52TEXTDrug therapy and other factors associated.pdf.txtDrug therapy and other factors associated.pdf.txtExtracted texttext/plain53https://www.arca.fiocruz.br/bitstream/icict/32947/3/Drug%20therapy%20and%20other%20factors%20associated.pdf.txt0c24aa877a38ba96df84bff2a7791be5MD53icict/329472019-05-08 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| dc.title.pt_BR.fl_str_mv |
Drug therapy and other factors associated with the development of acute kidney injury in critically ill patients: a cross-sectional study |
| title |
Drug therapy and other factors associated with the development of acute kidney injury in critically ill patients: a cross-sectional study |
| spellingShingle |
Drug therapy and other factors associated with the development of acute kidney injury in critically ill patients: a cross-sectional study Soares, Danielly Botelho Prática clinica Cuidados intensivos Utilização de drogas Inflamação dos nefrons Falência renal Clinical practice Critical care Drug utilization Nephrotoxicity Renal failure |
| title_short |
Drug therapy and other factors associated with the development of acute kidney injury in critically ill patients: a cross-sectional study |
| title_full |
Drug therapy and other factors associated with the development of acute kidney injury in critically ill patients: a cross-sectional study |
| title_fullStr |
Drug therapy and other factors associated with the development of acute kidney injury in critically ill patients: a cross-sectional study |
| title_full_unstemmed |
Drug therapy and other factors associated with the development of acute kidney injury in critically ill patients: a cross-sectional study |
| title_sort |
Drug therapy and other factors associated with the development of acute kidney injury in critically ill patients: a cross-sectional study |
| author |
Soares, Danielly Botelho |
| author_facet |
Soares, Danielly Botelho Mambrini, Juliana Vaz de Melo Botelho, Gabriela Rebouças Girundi, Flávia Fialho Botoni, Fernando Antonio Martins, Maria Auxiliadora Parreiras |
| author_role |
author |
| author2 |
Mambrini, Juliana Vaz de Melo Botelho, Gabriela Rebouças Girundi, Flávia Fialho Botoni, Fernando Antonio Martins, Maria Auxiliadora Parreiras |
| author2_role |
author author author author author |
| dc.contributor.author.fl_str_mv |
Soares, Danielly Botelho Mambrini, Juliana Vaz de Melo Botelho, Gabriela Rebouças Girundi, Flávia Fialho Botoni, Fernando Antonio Martins, Maria Auxiliadora Parreiras |
| dc.subject.other.pt_BR.fl_str_mv |
Prática clinica Cuidados intensivos Utilização de drogas Inflamação dos nefrons Falência renal |
| topic |
Prática clinica Cuidados intensivos Utilização de drogas Inflamação dos nefrons Falência renal Clinical practice Critical care Drug utilization Nephrotoxicity Renal failure |
| dc.subject.en.pt_BR.fl_str_mv |
Clinical practice Critical care Drug utilization Nephrotoxicity Renal failure |
| description |
Universidade Federal de Minas Gerais. Faculdade de Farmácia. Belo Horizonte, MG, Brazil. |
| publishDate |
2018 |
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2018 |
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2019-05-06T13:57:21Z |
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2019-05-06T13:57:21Z |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/article |
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article |
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SOARES, Danielly Botelho et al. Drug therapy and other factors associated with the development of acute kidney injury in critically ill patients: a cross-sectional study. PeerJ, v. 6, p. 1-19, 2018. |
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https://www.arca.fiocruz.br/handle/icict/32947 |
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2167-8359 |
| dc.identifier.doi.none.fl_str_mv |
10.7717/peerj.5405. eCollection 2018 |
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SOARES, Danielly Botelho et al. Drug therapy and other factors associated with the development of acute kidney injury in critically ill patients: a cross-sectional study. PeerJ, v. 6, p. 1-19, 2018. 2167-8359 10.7717/peerj.5405. eCollection 2018 |
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PeerJ Inc. |
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PeerJ Inc. |
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