Nephrotoxin Stewardship

Crit Care Clin. 2021 Apr;37(2):303-320. doi: 10.1016/j.ccc.2020.11.002. Epub 2021 Feb 13.

Abstract

Drugs are the third leading cause of acute kidney injury (AKI) in critically ill patients. Nephrotoxin stewardship ensures a structured and consistent approach to safe medication use and prevention of patient harm. Comprehensive nephrotoxin stewardship requires coordinated patient care management strategies for safe medication use, ensuring kidney health, and avoiding unnecessary costs to improve the use of nephrotoxins, renally eliminated drugs, and kidney disease treatments. Implementing nephrotoxin stewardship reduces medication errors and adverse drug events, prevents or reduces severity of drug-associated AKI, prevents progression to or worsening of chronic kidney disease, and alleviates financial burden on the health care system.

Keywords: Acute kidney injury; Adverse drug event; Critically ill; Intensive care unit; Medication error; Nephrotoxin stewardship.

Publication types

  • Review

MeSH terms

  • Acute Kidney Injury* / chemically induced
  • Critical Illness
  • Drug-Related Side Effects and Adverse Reactions*
  • Humans
  • Renal Insufficiency, Chronic*