Medication use and hospital‐acquired acute kidney injury: an electronic health record‐based study

Ling Li, Jannah Baker, Kasun Rathnayake, Sradha Kotwal, Johanna I. Westbrook, Richard Day, Zoltan Endre

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)
24 Downloads (Pure)

Abstract

Background and Aims: Medications remain an important contributor to the development of acute kidney injury (AKI). This study aimed to examine associations between (i) administration of medications known to reduce glomerular filtration rate (GFR), that is, GFR modifiers and subsequent hospital-acquired AKI; and (ii) potentially medication-related AKI and patient adverse outcomes.

Methods: A retrospective cohort study utilising electronic health record data of patients admitted to a tertiary hospital in Australia in 2015. Timing of medication administration was compared with timing of AKI development. AKI cases were identified using an algorithm based on serum creatinine level changes. Multilevel regression models were applied with adjustment for relevant demographic and clinical factors.

Results: Among 11 503 admissions, AKI was identified in 955 patients (8.3%) and 637 (66.7% of 955) were preceded by administration of a GFR modifier. Patients without prior AKI were 17% more likely to develop AKI after administration of these medications (adjusted odds ratio 1.17, 95% confidence interval (CI) 1.003–1.37). Older age and comorbidity with diabetes, acute myocardial infarction, peripheral vascular disease, liver cirrhosis and multiple myeloma were also significant predictors. Patients with potentially medication-related AKI were 11.69 times more likely to die in hospital (95% CI 7.84–17.43) and stayed 3.49 times longer in hospital (95% CI 3.26–3.73), compared with those without AKI.

Conclusions: Administration of medications contributing to the reduction of GFR is associated with an increased risk of hospital-acquired AKI and worse patient outcomes. Caution is required when prescribing these medications to patients at risk of developing AKI, and monitoring patients for deterioration is needed if administered.
Original languageEnglish
Pages (from-to)1625-1633
Number of pages9
JournalInternal Medicine Journal
Volume53
Issue number9
Early online date20 Oct 2022
DOIs
Publication statusPublished - Sept 2023

Bibliographical note

Copyright the Author(s) 2022. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

Keywords

  • acute kidney injury
  • glomerular filtration rate modifier
  • hospital length of stay
  • medication usage
  • mortality
  • readmissions

Fingerprint

Dive into the research topics of 'Medication use and hospital‐acquired acute kidney injury: an electronic health record‐based study'. Together they form a unique fingerprint.

Cite this