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Kidney Week

Abstract: TH-PO060

The Characteristic of Drug Spectrum That Induced AKI and Clinicopathological Features of Drug-Induced AKI

Session Information

Category: Acute Kidney Injury

  • 101 AKI: Epidemiology, Risk Factors, and Prevention

Authors

  • Cui, Yu, Zhejiang university, Hangzhou, China
  • Lang, Xiabing, Zhejiang University, Hangzhou, ZHEJIANG, China
  • Lan, Lan, Zhejiang University, Hangzhou, ZHEJIANG, China
Background

To analyze the changes and characteristics of drug spectrum , and to analyze the kidney pathological characteristics of drug-induced acute kidney injury.

Methods

Retrospective analysis the characteristics of the patients of our center in 2012 January to October 2016, who were diagnosed of drug-induced AKI. According to the data of medical history and clinical manifestations, record the related drugs, analysis of the changes of drug composition and the renal pathological characteristics.

Results

There are 228 patients diagnosed drug-induced AKI, and 51 patients underwent renal biopsy. In 228 patients, 70 patients were caused by antibacterial and antiviral drugs, 63 patients were caused by non-steroidal anti-inflammatory drugs, 17 patients were caused by Chinese herbal medicine, and other drugs including the ACEI / ARB drugs, proton pump inhibitors, weight-loss drugs, lipid-lowering drugs, anti-hepatitis B virus medicine, antidepressants, albumin, platinum chemotherapy drugs, colchicine, calcineurin inhibitors. 14 patients cannot named which drugs. There were 31 patients had 2 or 3 types of drugs used before kidney injury. The antibiotics and antiviral drugs were the most frequently drugs associated with AKI, including cephalosporins, acyclovir, azithromycin, clindamycin, levofloxacin. In the 51 underwent renal biopsy patients, 12 patients showed allergic interstitial nephritis, 19 cases of patients showed interstitial nephritis, 8 patients showed renal tubular epithelial cell injury, and 2 cases showed Minimal Change Nephropathy, 2 cases showed IgA nephropathy, 2 cases of mild mesangial hyperplasia with glomerulosclerosis.

Conclusion

The first three types of drugs induce AKI were antibiotics and antiviral drugs, non- steroidal anti-inflammatory drugs and Chinese herbal medicine. In the group of antibacterial drugs and antiviral drugs, the most common drugs were cephalosporins, acyclovir, clindamycin, azithromycin and levofloxacin, but not aminoglycosides. Allergic interstitial nephritis, interstitial nephritis and tubular epithelial cell injury is the main pathological manifestations of drug - induced AKI, but some patients had no obvious changes of the pathological performance.