An Integrated Approach for Representing Knowledge on the Potential of Drugs to Cause Acute Kidney Injury.

IF 4 2区 医学 Q1 PHARMACOLOGY & PHARMACY
Daniel Fernández-Llaneza, Romy M P Vos, Joris E Lieverse, Helen R Gosselt, Sandra L Kane-Gill, Teun van Gelder, Joanna E Klopotowska
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Abstract

Introduction and objective: The recent rise in acute kidney injury (AKI) incidence, with approximately 30% attributed to potentially preventable adverse drug events (ADEs), poses challenges in evaluating drug-induced AKI due to polypharmacy and other risk factors. This study seeks to consolidate knowledge on the drugs with AKI potential from four distinct sources: (i) bio(medical) peer-reviewed journals; (ii) spontaneous reporting systems (SRS); (iii) drug information databases (DIDs); and (iv) NephroTox website. By harnessing the potential of these underutilised sources, our objective is to bridge gaps and enhance the understanding of drug-induced AKI.

Methods: By searching Medline, studies with lists of drugs with AKI potential established through consensus amongst medical experts were selected. A final list of 63 drugs was generated aggregating the original studies. For these 63 drugs, the AKI reporting odds ratios (RORs) using three SRS databases, the average frequency of ADEs from four different DIDs and the number of published studies identified via NephroTox was reported.

Results: Drugs belonging to the antivirals, antibacterials, and non-steroidal anti-inflammatory pharmacological classes exhibit substantial consensus on AKI potential, which was also reflected in strong ROR signals, frequent to very frequent AKI-related ADEs and a high number of published studies reporting adverse kidney events as identified via NephroTox. Renin-angiotensin aldosterone system inhibitors and diuretics also display comparable signal strengths, but this can be attributed to expected haemodynamic changes. More variability is noted for proton-pump inhibitors.

Conclusions: By integrating four disjointed sources of knowledge, we have created a novel, comprehensive resource on drugs with AKI potential, contributing to kidney safety improvement efforts.

表示药物导致急性肾损伤可能性知识的综合方法。
引言和目的:最近,急性肾损伤(AKI)发病率上升,其中约 30% 归因于潜在可预防的药物不良事件 (ADE),这给评估由多种药物和其他风险因素引起的药物性 AKI 带来了挑战。本研究试图从以下四个不同来源整合有关可能引发 AKI 的药物的知识:(i) 生物(医学)同行评审期刊;(ii) 自发报告系统 (SRS);(iii) 药物信息数据库 (DID);(iv) NephroTox 网站。我们的目标是利用这些未得到充分利用的资料来源的潜力,缩小差距并加深对药物诱发 AKI 的了解:方法:通过搜索 Medline,筛选出医学专家一致认为可能引发 AKI 的药物清单。在汇总了原始研究后,最终得出了一份包含 63 种药物的清单。对于这 63 种药物,报告了使用三个 SRS 数据库得出的 AKI 报告几率(ROR)、四个不同 DID 的 ADE 平均频率以及通过 NephroTox 确定的已发表研究的数量:结果:抗病毒药物、抗菌药物和非甾体抗炎药物类别的药物在潜在的肾脏损伤方面表现出很大的共识,这也反映在强烈的ROR信号、频繁或非常频繁的肾脏损伤相关ADE以及通过NephroTox确定的大量已发表的报告肾脏不良事件的研究中。肾素-血管紧张素醛固酮系统抑制剂和利尿剂也显示出相似的信号强度,但这可归因于预期的血流动力学变化。质子泵抑制剂的变化更大:通过整合四种互不关联的知识来源,我们创建了一个新颖、全面的资源库,其中包含了可能导致 AKI 的药物,为改善肾脏安全做出了贡献。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Drug Safety
Drug Safety 医学-毒理学
CiteScore
7.60
自引率
7.10%
发文量
112
审稿时长
6-12 weeks
期刊介绍: Drug Safety is the official journal of the International Society of Pharmacovigilance. The journal includes: Overviews of contentious or emerging issues. Comprehensive narrative reviews that provide an authoritative source of information on epidemiology, clinical features, prevention and management of adverse effects of individual drugs and drug classes. In-depth benefit-risk assessment of adverse effect and efficacy data for a drug in a defined therapeutic area. Systematic reviews (with or without meta-analyses) that collate empirical evidence to answer a specific research question, using explicit, systematic methods as outlined by the PRISMA statement. Original research articles reporting the results of well-designed studies in disciplines such as pharmacoepidemiology, pharmacovigilance, pharmacology and toxicology, and pharmacogenomics. Editorials and commentaries on topical issues. Additional digital features (including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations) can be published with articles; these are designed to increase the visibility, readership and educational value of the journal’s content. In addition, articles published in Drug Safety Drugs may be accompanied by plain language summaries to assist readers who have some knowledge of, but not in-depth expertise in, the area to understand important medical advances.
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