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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| Format: | Article |
| Language: | English |
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MDPI AG
2021-10-01
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| Series: | Children |
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| Online Access: | https://www.mdpi.com/2227-9067/8/11/948 |
| _version_ | 1797510741632221184 |
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| author | Claire Lefebvre Marc Dorais Erin Hessey Michael Zappitelli |
| author_facet | Claire Lefebvre Marc Dorais Erin Hessey Michael Zappitelli |
| author_sort | Claire Lefebvre |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-03-10T05:36:31Z |
| format | Article |
| id | doaj.art-9839368224a041f19ac95b47638f2394 |
| institution | Directory Open Access Journal |
| issn | 2227-9067 |
| language | English |
| last_indexed | 2024-03-10T05:36:31Z |
| publishDate | 2021-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Children |
| spelling | doaj.art-9839368224a041f19ac95b47638f23942023-11-22T22:54:18ZengMDPI AGChildren2227-90672021-10-0181194810.3390/children8110948Outpatient Nephrotoxic Medication Prescription after Pediatric Intensive Care Acute Kidney InjuryClaire Lefebvre0Marc Dorais1Erin Hessey2Michael Zappitelli3Department of Pediatrics, Centre Hospitalier Universitaire Sainte-Justine, Montreal, QC H3T 1C5, CanadaStatSciences Inc., Notre-Dame-de-l’Île-Perrot, QC J7V 7P2, CanadaFaculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2R3, CanadaDepartment of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC H3A 1A2, CanadaBackground: 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.https://www.mdpi.com/2227-9067/8/11/948pediatricsrenalkidney diseasenephrotoxicityprescription patterns |
| spellingShingle | Claire Lefebvre Marc Dorais Erin Hessey Michael Zappitelli Outpatient Nephrotoxic Medication Prescription after Pediatric Intensive Care Acute Kidney Injury Children pediatrics renal kidney disease nephrotoxicity prescription patterns |
| title | 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_short | Outpatient Nephrotoxic Medication Prescription after Pediatric Intensive Care Acute Kidney Injury |
| title_sort | outpatient nephrotoxic medication prescription after pediatric intensive care acute kidney injury |
| topic | pediatrics renal kidney disease nephrotoxicity prescription patterns |
| url | https://www.mdpi.com/2227-9067/8/11/948 |
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