医療情報データベースを活用した抗菌薬による薬剤性急性腎障害の発症及び慢性腎臓病へ移行するリスク因子の探索

  • 家田 維哉
    名古屋市立大学大学院薬学研究科レギュラトリーサイエンス分野
  • 黒田 侑花
    名古屋市立大学大学院薬学研究科レギュラトリーサイエンス分野
  • 松本 貴大
    名古屋市立大学大学院薬学研究科レギュラトリーサイエンス分野
  • 山下 彩花
    名古屋市立大学大学院薬学研究科レギュラトリーサイエンス分野
  • 渡邊 崇
    名古屋市立大学大学院薬学研究科レギュラトリーサイエンス分野
  • 堀 雄史
    浜松医科大学医学部附属病院薬剤部
  • 木村 通男
    川崎医療福祉大学医療福祉マネジメント学部医療情報学科
  • 川上 純一
    浜松医科大学医学部附属病院薬剤部
  • 頭金 正博
    名古屋市立大学大学院薬学研究科レギュラトリーサイエンス分野

書誌事項

タイトル別名
  • Exploration of Risk Factors of the Onset of Antibiotics-induced Acute Kidney Injury and Its Transfer to Chronic Kidney Disease Using the Medical Information Database

抄録

<p>Drug-induced acute kidney injury (AKI) is a serious adverse drug reaction, which results in a significant decline in renal function and is known to progress to chronic kidney disease (CKD). Therefore, appropriate drug therapy is important to avoid the risk of drug-induced AKI and CKD, which are serious concerns in clinical practice. In this study, using the medical information database of Hamamatsu University Hospital, we investigated the risk factors that accelerate the onset of drug-induced AKI or its progression to CKD in patients who received aminoglycoside antibiotics (AGs) or glycopeptide antibiotics (GPs), which are strongly associated with drug-induced AKI and CKD. We performed logistic regression analysis using patients’ background, laboratory test results, and concomitant drug use, among other such factors as explanatory variables and drug-induced AKI or CKD onset as objective variables to explore the risk factors for drug-induced AKI and CKD. Our results showed that co-administration of amphotericin B, piperacillin-tazobactam and other AGs and GPs, increased serum creatinine (Scr) and chloride concentrations, serum lactate dehydrogenase activity, and decreased serum albumin concentration were risk factors for drug-induced AKI onset. Moreover, a reduced blood urea nitrogen : Scr ratio at drug-induced AKI onset served as a risk factor for CKD. These results suggest that careful monitoring of the aforementioned factors is important to ensure appropriate usage of these drugs in patients treated with AGs and GPs.</p>

収録刊行物

  • 薬学雑誌

    薬学雑誌 144 (4), 447-462, 2024-04-01

    公益社団法人 日本薬学会

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