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Related Concept Videos

Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

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Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
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Heart Failure Drugs: Inhibitors of Renin-Angiotensin System01:26

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

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The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
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Acute Kidney Injury VI: Nursing Management01:22

Acute Kidney Injury VI: Nursing Management

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Acute Kidney Injury (AKI) results in an inability to maintain fluid, electrolyte, and acid-base balance. Effective nursing management is critical in improving patient outcomes and includes comprehensive patient assessment and targeted interventions.Comprehensive Patient AssessmentA detailed history collection is essential, focusing on any recent infections, nephrotoxic medication use, or chronic conditions such as hypertension and diabetes that may contribute to AKI. During the physical...
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Acute Kidney Injury V: Interprofessional Care01:20

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Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...
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Heart Failure Drugs: Diuretics01:22

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Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
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Antihypertensive Drugs: Potassium-Sparing Diuretics01:28

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Liddle syndrome is a genetically inherited form of hypertension characterized by the overactivity of epithelial sodium channels in the nephron, the functional unit of the kidney. This heightened activity leads to increased sodium reabsorption and excessive excretion of potassium. To counteract this, potassium-sparing diuretics such as amiloride are used. They function by blocking these sodium channels, thereby reducing the influx of sodium into the epithelial cells and minimizing the loss of...
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Acute Kidney Injury Model Induced by Cisplatin in Adult Zebrafish
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Antihypertensive Drug Combinations Modify Cisplatin-induced Acute Kidney Injury.

Koji Takeuchi1, Rintaro Sogawa1, Satoko Tsuruhashi1

  • 1Department of Pharmacy, Saga University Hospital, Saga, Japan.

In Vivo (Athens, Greece)
|April 28, 2022
PubMed
Summary

Concomitant use of calcium channel blockers (CCBs) and renin-angiotensin system (RAS) inhibitors with cisplatin (CDDP) significantly increases the risk of acute kidney injury (AKI). Healthcare providers should monitor patients closely for AKI when these drug combinations are prescribed.

Keywords:
Cisplatinacute kidney injuryantihypertensive drug

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Area of Science:

  • Nephrology
  • Pharmacology
  • Oncology

Background:

  • Limited evidence exists on the nephrotoxicity of combined calcium channel blockers (CCBs) and renin-angiotensin system (RAS) inhibitors with cisplatin (CDDP).
  • Acute kidney injury (AKI) is a potential adverse effect of CDDP treatment.

Purpose of the Study:

  • To investigate the association between antihypertensive drug combinations and CDDP-related AKI.
  • To evaluate the risk of AKI when CCBs and RAS inhibitors are used concurrently with CDDP.

Main Methods:

  • Analysis of 544,864 reports from the Japanese Adverse Drug Event Report database (2004-2020).
  • Calculation of reporting odds ratios (ROR) and confidence intervals (CI) for AKI, adjusting for confounding factors.
  • Assessment of individual drug use and combined use with CDDP.

Main Results:

  • CDDP, CCBs, and RAS inhibitors were all identified as risk factors for AKI.
  • Concomitant use of CCBs, RAS inhibitors, and CDDP showed a significantly higher ROR for AKI (adjusted ROR 7.28; 95% CI=5.56-9.54) compared to individual drug use.
  • The combined drug regimen presented a notable signal for AKI.

Conclusions:

  • Concomitant use of CCBs and RAS inhibitors with CDDP is associated with an increased risk of AKI.
  • Increased vigilance for AKI is warranted in patients receiving CDDP who are also taking CCBs and RAS inhibitors.
  • This finding highlights the importance of careful medication management in cancer patients undergoing chemotherapy.