Drug-related acute renal failure in hospitalised patients

Introduction: The information available on the incidence and the characteristics of patients with acute renal failure (ARE) related to drugs is scarce. Objectives: To estimate the incidence of drug-related ARE in hospitalised patients and to compare their characteristics with those of patients with ARE due to other causes. Material and methods: We selected a prospective cohort of patients with ARE during hospital admission (July 2010-July 2011). Information on patients' demographics, medical antecedents, ARE risk factors, ARE severity according to the RIFLE classification and hospital drug administration was collected. We analysed the relationship of drugs with the ARE episodes using Spanish Pharmacovigilance System methods and algorithm. Results: A total of 194 cases had an episode of hospital-acquired ARE The median age of patients was 72 years [IQR 20]; 60% were men. The ARE incidence during hospitalization was 9.6 per 1,000 admissions. According to the RIFLE classification, a risk of kidney damage or kidney injury was present in 77.8% of cases. In 105 (54.1%) cases, ARF was drug-related; the drugs most frequently involved were diuretics, agents acting on the renin-angiotensin system, immunosuppressants, beta-blocking agents, calcium channel blockers, contrast media and non-steroid anti-inflammatory drugs. Patients with drug-related ARE had more multi-morbidity, fewer ARE risk factors and lower mortality. Conclusions: Half of ARE episodes during hospitalisation were drug related. Patients with drug-related ARE had higher cardiovascular morbidity than those with ARE related to other causes, but they had a lower frequency of ARE risk factors and mortality. (C) 2015 Sociedad Espanola de Nefrologia. Published by Elsevier Espana, S.L.U.