Congratulations to Zac Cox, associate professor of pharmacy practice for a recent publication in the ADE Manuscript. The Clinical Journal of the American Society of Nephrology is an official publication of the American Society of Nephrology. It has an impact factor of 5.2 and is regarded as a premier journal in the field of nephrology.
Cox and team explored the contribution of nephrotoxic or renally eliminated medications to medication-related morbidity and mortality experienced by patients with acute kidney injury (AKI). The study described the type and severity of these adverse drug events in hospitalized patients during AKI or recovery from AKI. Forty-three percent of our study population experienced an event, consisting of 73 adverse drug events, 93 potential adverse drug events (e.g. “ a near miss”), and 33 potential therapeutic failures from failure to adjust medications for improving renal function during recovery from AKI. The majority of these events were graded as “serious” or “life-threatening” in severity, including 9 events requiring a rapid response team evaluation or intensive care unit admission and 2 fatalities. In a multivariate analysis, compared to other drug classes, ACEI/ARBs and parenteral anticoagulants were associated with more adverse events than expected based on their frequency of use. As 66% of the events in our study were judge preventable, our findings illustrate the intense vigilance required for pharmacotherapy monitoring during AKI and recovery from AKI. AKI patients may be at higher risk of ADEs because therapeutic decisions are based on markers of renal function (e.g. serum creatinine) that lag behind acute changes in glomerular filtration rate.
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Cox ZL, McCoy AB, Matheny ME, Bhave G, Peterson NB, Siew ED, Lewis J, Danciu I, Bian A, Shintani A, Ikizler TA, Neal EB, Peterson JF. Adverse Drug Events during Acute Kidney Injury and its Recovery. Clinical Journal of the American Society of Nephrology. Published Online before in print on March 2013 doi: 10.2215/ CJN.11921112