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Acute kidney injury and increasing nephrotoxic-medication exposure in noncritically-ill children

Brady S Moffett1, Stuart L Goldstein

  • 1Texas Children's Hospital, Department of Pharmacy, 6621 Fannin Street, MC 2-2510, Houston, TX 77030, USA. bsmoffet@texaschildrens.org

Clinical Journal of the American Society of Nephrology : CJASN
|January 8, 2011
PubMed

Insights

Hospitalized children exposed to multiple nephrotoxic medications face a higher risk of acute kidney injury (AKI). This increases hospital costs and patient morbidity, highlighting the need for careful medication management in pediatric care.

Area of Science:

  • Pediatric Nephrology
  • Clinical Pharmacology
  • Hospital Medicine

Background:

  • Acute kidney injury (AKI) in children leads to significant morbidity and mortality.
  • Nephrotoxic medication exposure is a primary contributor to AKI in pediatric populations.
  • Limited data exist on specific nephrotoxic medication risks in children.

Purpose of the Study:

  • To investigate the association between nephrotoxic medication exposure and AKI risk.
  • To quantify the risk of AKI in hospitalized children without pre-existing renal conditions.
  • To evaluate the impact of nephrotoxic medication exposure on pediatric AKI development.

Main Methods:

  • Retrospective case-control study design.
  • Inclusion of pediatric patients (1 day to 18 years) without prior renal insufficiency.
  • AKI diagnosis based on pediatric-modified Risk, Injury, Failure, Loss, End-Stage (pRIFLE) criteria; controls matched for age, gender, and disease state.

Main Results:

  • 33.8% of hospitalized children developed AKI.
  • Patients with AKI had longer hospital stays and higher costs.
  • Exposure to more nephrotoxic medications, and for longer durations, significantly increased AKI risk.

Conclusions:

  • Exposure to three or more nephrotoxic medications elevates pediatric AKI risk.
  • Increased AKI risk is associated with greater hospital costs and patient morbidity.
  • This study underscores the importance of monitoring nephrotoxic medication exposure in hospitalized children.
Abstract

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