Outpatient Nephrotoxic Medication Prescription after Pediatric Intensive Care Acute Kidney Injury

Background: Nephrotoxic medication (NTM) avoidance may prevent further kidney damage in children with acute kidney injury (AKI). We compared outpatient NTM prescriptions in children with or without AKI during pediatric intensive care (PICU) hospitalization. We hypothesize that children with AKI are...

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Autores principales:	Claire Lefebvre, Marc Dorais, Erin Hessey, Michael Zappitelli
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	pediatrics renal kidney disease nephrotoxicity prescription patterns Pediatrics RJ1-570
Acceso en línea:	https://doaj.org/article/9839368224a041f19ac95b47638f2394
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spelling	oai:doaj.org-article:9839368224a041f19ac95b47638f23942021-11-25T17:13:49ZOutpatient Nephrotoxic Medication Prescription after Pediatric Intensive Care Acute Kidney Injury10.3390/children81109482227-9067https://doaj.org/article/9839368224a041f19ac95b47638f23942021-10-01T00:00:00Zhttps://www.mdpi.com/2227-9067/8/11/948https://doaj.org/toc/2227-9067Background: Nephrotoxic medication (NTM) avoidance may prevent further kidney damage in children with acute kidney injury (AKI). We compared outpatient NTM prescriptions in children with or without AKI during pediatric intensive care (PICU) hospitalization. We hypothesize that children with AKI are prescribed NTMs at the same rate as those without it. Methods: This was a retrospective administrative data study of children <18 years, admitted to two PICUs in Montreal, Canada, from 2003 to 2005, with ≥30 days of provincial drug coverage. We evaluated the presence of ≥3 outpatient NTM prescriptions during the first year and 5 years after PICU discharge. Results: Of 970 children, 23% had PICU AKI. In the 1st–5th years after discharge, 18% AKI vs. 10% non-AKI and 13% AKI vs. 4% non-AKI patients received ≥3 NTM prescriptions, respectively. There was no association between PICU AKI and prescription of ≥3 NTMs during the first year (adjusted RR 1.02 [95% CI 0.95–1.10]) nor in the first 5 years post-discharge (adjusted RR 1.04 [95%CI 0.96–1.12]). Conclusions: By offering a better understanding of the current state of outpatient NTM prescription to children with AKI, our study is a step toward considering strategies such as knowledge translation interventions for decreasing NTM exposure and improving outcomes in children with AKI.Claire LefebvreMarc DoraisErin HesseyMichael ZappitelliMDPI AGarticlepediatricsrenalkidney diseasenephrotoxicityprescription patternsPediatricsRJ1-570ENChildren, Vol 8, Iss 948, p 948 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	pediatrics renal kidney disease nephrotoxicity prescription patterns Pediatrics RJ1-570
spellingShingle	pediatrics renal kidney disease nephrotoxicity prescription patterns Pediatrics RJ1-570 Claire Lefebvre Marc Dorais Erin Hessey Michael Zappitelli Outpatient Nephrotoxic Medication Prescription after Pediatric Intensive Care Acute Kidney Injury
description	Background: Nephrotoxic medication (NTM) avoidance may prevent further kidney damage in children with acute kidney injury (AKI). We compared outpatient NTM prescriptions in children with or without AKI during pediatric intensive care (PICU) hospitalization. We hypothesize that children with AKI are prescribed NTMs at the same rate as those without it. Methods: This was a retrospective administrative data study of children <18 years, admitted to two PICUs in Montreal, Canada, from 2003 to 2005, with ≥30 days of provincial drug coverage. We evaluated the presence of ≥3 outpatient NTM prescriptions during the first year and 5 years after PICU discharge. Results: Of 970 children, 23% had PICU AKI. In the 1st–5th years after discharge, 18% AKI vs. 10% non-AKI and 13% AKI vs. 4% non-AKI patients received ≥3 NTM prescriptions, respectively. There was no association between PICU AKI and prescription of ≥3 NTMs during the first year (adjusted RR 1.02 [95% CI 0.95–1.10]) nor in the first 5 years post-discharge (adjusted RR 1.04 [95%CI 0.96–1.12]). Conclusions: By offering a better understanding of the current state of outpatient NTM prescription to children with AKI, our study is a step toward considering strategies such as knowledge translation interventions for decreasing NTM exposure and improving outcomes in children with AKI.
format	article
author	Claire Lefebvre Marc Dorais Erin Hessey Michael Zappitelli
author_facet	Claire Lefebvre Marc Dorais Erin Hessey Michael Zappitelli
author_sort	Claire Lefebvre
title	Outpatient Nephrotoxic Medication Prescription after Pediatric Intensive Care Acute Kidney Injury
title_short	Outpatient Nephrotoxic Medication Prescription after Pediatric Intensive Care Acute Kidney Injury
title_full	Outpatient Nephrotoxic Medication Prescription after Pediatric Intensive Care Acute Kidney Injury
title_fullStr	Outpatient Nephrotoxic Medication Prescription after Pediatric Intensive Care Acute Kidney Injury
title_full_unstemmed	Outpatient Nephrotoxic Medication Prescription after Pediatric Intensive Care Acute Kidney Injury
title_sort	outpatient nephrotoxic medication prescription after pediatric intensive care acute kidney injury
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/9839368224a041f19ac95b47638f2394
work_keys_str_mv	AT clairelefebvre outpatientnephrotoxicmedicationprescriptionafterpediatricintensivecareacutekidneyinjury AT marcdorais outpatientnephrotoxicmedicationprescriptionafterpediatricintensivecareacutekidneyinjury AT erinhessey outpatientnephrotoxicmedicationprescriptionafterpediatricintensivecareacutekidneyinjury AT michaelzappitelli outpatientnephrotoxicmedicationprescriptionafterpediatricintensivecareacutekidneyinjury
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Outpatient Nephrotoxic Medication Prescription after Pediatric Intensive Care Acute Kidney Injury

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