Pathological Profile and Recovery Rate in Patients With Drug-Induced Acute Kidney Injury: A Retrospective Study From North-East India

Abstract

Introduction : Drug-induced acute kidney injury (DI-AKI) is a common renal event with long-term sequelae. However, pathological profile and recovery rate are scarcely reported from north-east India. Thus, we evaluated the commonly implicated nephrotoxic drugs, pathological findings on renal biopsy, and recovery following treatment in patients with DI-AKI. Materials and MethodsThis retrospective, observational study involved the review of Nephrology AKI registry of a tertiary care institute. The review involved data of the adult patients diagnosed with DI-AKI over a period of 24 months (August 2020 to July 2022). Results : During the study period, a total of 182 patients developed DI-AKI. AKI was predominantly caused by antimicrobials (33.52%), alternative medicine (15.38%), and NSAIDs (11.54%).The younger and elderly patients were involved in significantly higher consumption of NSAIDs and alternative medicine, respectively (p-values<0.05). Biopsy was performed in 79 (43.41%) patients, and findings included mainly acute interstitial nephritis (AIN, 37.97%), allergic interstitial nephritis (ALIN, 18.99%), and acute tubular nephropathy (ATN, 12.66%). Steroid therapy and hemodialysis were required in 66 (36.26%) and 105 (57.69%) patients, respectively. At a mean follow-up of 124.78 ± 30.15 days, complete and partial recovery was observed in 136 (74.73%) and 12 (6.59%) patients, respectively. Recovery rate did not differ significant according to class of drugs (p-value=0.194). Conclusion : Antimicrobials, alternative medicine, and NSAIDs were predominantly implicated in DI-AKI. AIN, ALIN, and ATN were the most common biopsy findings with absence of any correlation with the offending agents. Around three quarters of the patients recovered completely.