ArticleClinical journal of the American Society of Nephrology : CJASN2023
Nephrotoxin Exposure and Acute Kidney Injury in Adults.
Article in Clinical journal of the American Society of Nephrology : CJASN, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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17 citing papers in PubMed.
- Risk of acute kidney injury in patients on concomitant vancomycin and piperacillin-tazobactam compared to vancomycin and other beta-lactam agents: a large multicenter retrospective cohort study from China.Microbiology spectrum · 2026Observational
- The Safety of Single Aminoglycoside Dose in Emergency Departments (SAD-ED) Among Patients With and Without Chronic Kidney Disease: A Retrospective Cohort Study.Emergency medicine Australasia : EMA · 2026Article
- Article
- Mechanisms Linking Recurrent Bacterial Urinary Tract Infections to Chronic Kidney Disease Progression.International journal of molecular sciences · 2026Review
- Risk of Acute Kidney Injury Associated With Nephrotoxic Burden in Hospitalized Patients: A Scoping Review.Clinical pharmacology and therapeutics · 2026Article
- The impacts of angiotensin converting enzyme inhibitors and angiotensin receptor blockers on rates of acute kidney injury in hospitalized adults receiving multiple nephrotoxins.BMC nephrology · 2026Article
- Hospital physicians' reasoning and information needs in the diagnosis and prevention of drug-induced acute kidney injury: a qualitative study.BMC nephrology · 2026Article
- Prevalence of acute kidney injury and nephrotoxic drug exposure in premature and low birth weight neonates admitted to intensive care units at Muhimbili National Hospital, Dar es Salaam.BMC pediatrics · 2026Article
- Temporal Recurrent Neural Networks for Predicting Acute Kidney Injury Recovery by Time of Discharge.AMIA Joint Summits on Translational Science proceedings. AMIA Joint Summits on Translational Science · 2026Article
- Acute Kidney Injury Diagnostic Accuracy and Implications of Different Baseline Creatinine Equations.Kidney international reports · 2025Article
- Injured renal cell membrane encapsulated ICG/CORM-401 for homologous targeted NIR theranostics of acute kidney injury.Journal of nanobiotechnology · 2025Article
- A clinical decision support system promotes the appropriate use of drugs in hospitalized patients with kidney impairment.Journal of pharmaceutical health care and sciences · 2025Review
- The Acute Kidney Intervention and Pharmacotherapy (AKIP) List: Standardized List of Medications That Are Renally Eliminated and Nephrotoxic in the Acutely Ill.The Annals of pharmacotherapy · 2025Article
- An Integrated Approach for Representing Knowledge on the Potential of Drugs to Cause Acute Kidney Injury.Drug safety · 2025Article
- Predicting Nephrotoxic Acute Kidney Injury in Hospitalized Adults: A Machine Learning Algorithm.Kidney medicine · 2024Article
- The Effects of Pharmacist-Led Medication Therapy Management on Medication Adherence and Use of Non-Steroidal Anti-Inflammatory Drug in Patients with Pre-End Stage Renal Disease.Patient preference and adherence · 2024Article
- System-Based Solutions to Minimizing Nephrotoxin-Induced Acute Kidney Injury.Clinical journal of the American Society of Nephrology : CJASN · 2023Article
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8 authors.
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Abstract
backgroundRates of nephrotoxic AKI are not well described in adults due to lack of a clear definition, debate over which drugs should be considered nephrotoxins, and illness-related confounding. Nephrotoxic Injury Negated by Just-in Time Action (NINJA), a program that reduces rates of nephrotoxic AKI in pediatric populations, may be able to address these concerns, but whether NINJA can be effectively applied to adults remains unclear.
methodsIn this retrospective cohort study conducted at the University of Iowa Hospital, we included adult patients admitted to a general hospital floor for ≥48 hours during 2019. The NINJA algorithm screened charts for high nephrotoxin exposure and AKI. After propensity score matching, Cox proportional hazard modeling was used to evaluate the relationship between nephrotoxic exposure and all-stage AKI, stage 2-3 AKI, or death. Additional analyses evaluated the most frequent nephrotoxins used in this population.
resultsOf 11,311 patients, 1527 (16%) had ≥1 day of high nephrotoxin exposure. Patients with nephrotoxic exposures subsequently developed AKI in 29% of cases, and 22% of all inpatient AKI events met nephrotoxic AKI criteria. Common nephrotoxins were vancomycin, iodinated contrast dye, piperacillin-tazobactam, acyclovir, and lisinopril. After propensity score matching, Cox proportional hazard models for high nephrotoxin exposure were significantly associated with all AKI (hazard ratio [HR] 1.43, 1.19-1.72, P<0.001), stage 2-3 AKI (HR 1.78, 1.18-2.67, P=0.006), and mortality (HR 2.12, 1.09-4.11, P=0.03).
conclusionsNephrotoxin exposure in adults is common and is significantly associated with AKI development, including stage 2-3 AKI.
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