Drug-induced acute kidney injury in the critically ill adult: recognition and prevention strategies

Crit Care Med. 2010 Jun;38(6 Suppl):S169-74. doi: 10.1097/CCM.0b013e3181de0c60.

Abstract

Acute kidney injury is common in critically ill patients, with an incidence of 20% to 30%. It has been associated with increased mortality, hospital length of stay, and total cost. A number of strategies may be beneficial in identifying at-risk patients. In addition, using preventive measures and avoiding nephrotoxic medications are paramount in reducing the overall incidence. Although multifactorial, drug-induced acute kidney injury may account for up to 25% of all cases of acute kidney injury in this population. This review focuses on the mechanisms of drug-induced acute kidney injury in critically ill adults and offers preventive strategies when appropriate.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Acute Kidney Injury / chemically induced*
  • Acute Kidney Injury / diagnosis
  • Acute Kidney Injury / prevention & control*
  • Adult
  • Aminoglycosides / adverse effects
  • Amphotericin B / adverse effects
  • Angiotensin Receptor Antagonists
  • Angiotensin-Converting Enzyme Inhibitors / adverse effects
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects
  • Antifungal Agents / adverse effects
  • Calcineurin Inhibitors
  • Contrast Media / adverse effects
  • Critical Care / methods*
  • Critical Illness
  • Cyclooxygenase Inhibitors / adverse effects
  • Decision Support Systems, Clinical
  • Drug-Related Side Effects and Adverse Reactions / diagnosis
  • Drug-Related Side Effects and Adverse Reactions / etiology
  • Drug-Related Side Effects and Adverse Reactions / prevention & control
  • Humans
  • Medical Order Entry Systems

Substances

  • Aminoglycosides
  • Angiotensin Receptor Antagonists
  • Angiotensin-Converting Enzyme Inhibitors
  • Anti-Inflammatory Agents, Non-Steroidal
  • Antifungal Agents
  • Calcineurin Inhibitors
  • Contrast Media
  • Cyclooxygenase Inhibitors
  • Amphotericin B