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Drug-associated acute kidney disease: data from a world pharmacovigilance database

2024-07Journal article Open access
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dc.contributor.authorBaptista, Alexandre
dc.contributor.authorMarreiros, Ana
dc.contributor.authorMacedo, Ana
dc.contributor.authorCoelho, André
dc.date.accessioned2024-07-24T10:44:05Z
dc.date.available2024-07-24T10:44:05Z
dc.date.issued2024-07
dc.description.abstractBackground: Drugs are a frequent cause of nephrotoxicity, especially in the context of acute kidney disease (AKD), with a significant number of cases being drug-associated. The WHO's VigiBase is a powerful tool for identifying drugs described and associated with the development of AKD. Methods: We retrieved data from the period 1968 to 2022 regarding notifications of adverse drug reactions (ADR). The extracted medications were evaluated for their nephrotoxicity based on the bibliographic score (BS) developed through pre-selected references. The main medications involved were classified as 'non-nephrotoxic', 'potentially nephrotoxic', and 'nephrotoxic'. We utilized the IC025 and reporting odds ratio (ROR) disproportionality indexes to study the relationship between medications and the odds of being included in an AKD notification. Results: During the period, a total of 33,932,051 notifications were obtained, revealing 435,677 cases related to drug-associated AKD following MedDRA term filtering, predominantly affecting males aged 45-64. We identified 8,991 active ingredients or suspected combinations associated with AKD development, with the ATC class A - Alimentary Tract and Metabolism being the most frequently described. Among the medications most strongly associated with this phenotype, classes J and N stood out. Among the most notable medications collected, 8.3% were classified as "non-nephrotoxic," 16.7% as "potentially nephrotoxic," and 75% as "known nephrotoxic." Notable active ingredients included cobicistat + elvitegravir + emtricitabine + tenofovir disoproxil (IC025 8.7; ROR 786.96), inotersen (IC025 7.7; ROR 604.57), emtricitabine + tenofovir disoproxil (IC025 7.9; ROR 432.36), esomeprazole (IC025 6.8; ROR 184.23), and pantoprazole (IC025 6.3; ROR 109.86), with proton pump inhibitors dominating the top four positions among the most frequently involved medications. Conclusion: AKD is a frequent adverse reaction in VigiBase, with a significantly high reported mortality rate. Evaluation of the notifications revealed medications with a high disproportionality index and a strong association with AKD. We also highlight the potential nephrotoxic role of less suspected medications. This study emphasizes the need to consider AKD as a condition potentially associated with iatrogenic etiology, highlighting various medications and their respective involvement in the various possible manifestations of AKD.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationBaptista A, Marreiros A, Macedo A, Coelho A. Drug-associated acute kidney disease: data from a world pharmacovigilance database. Cureus. 2024;16(7):e63636.pt_PT
dc.identifier.doi10.7759/cureus.63636pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.21/17586
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherSpringer Naturept_PT
dc.relation.publisherversionhttps://assets.cureus.com/uploads/original_article/pdf/268698/20240702-28110-1mct7m6.pdfpt_PT
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/pt_PT
dc.subjectPharmacologypt_PT
dc.subjectPharmacoepidemiologypt_PT
dc.subjectDrug-associated nephrotoxicitypt_PT
dc.subjectPharmacovigilancept_PT
dc.subjectAdverse drug reactionspt_PT
dc.subjectAcute kidney diseasept_PT
dc.titleDrug-associated acute kidney disease: data from a world pharmacovigilance databasept_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.issue7pt_PT
oaire.citation.startPagee63636pt_PT
oaire.citation.titleCureuspt_PT
oaire.citation.volume16pt_PT
person.familyNameFerreira Ramos Coelho
person.givenNameAndré Filipe
person.identifier.ciencia-id291E-1AC6-86FA
person.identifier.orcid0000-0003-1872-8131
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublicatione00e9fd8-697d-4e70-acd3-e5a5169360ed
relation.isAuthorOfPublication.latestForDiscoverye00e9fd8-697d-4e70-acd3-e5a5169360ed

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