The use of nephrotoxic drugs in patients with chronic kidney disease

Okoro, Roland Nnaemeka; Farate, Victor Titus

doi:10.1007/s11096-019-00811-9

Cited by 36 publications

(54 citation statements)

References 31 publications

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“…Further evidence showed that the number of several medications was the most predictive factor of an inappropriate prescription [26,27]. Contrary to our data, comorbidities did not affect the likelihood of inappropriate prescriptions in hospitalized elderly patients [20]. However, the different context has to be taken into account.…”

Section: Discussioncontrasting

confidence: 94%

“…In addition, the proportion of contraindicated prescriptions was greater in patients in the G4/G5 CKD stages compared with stages G3a and G3b, as shown in another study [26]. However, a recent study found that G2-G3 patients received significantly more contraindicated drugs prescriptions than late-stage CKD subjects [20].…”

Section: Discussionmentioning

confidence: 83%

“…This is the first study concerning the evaluation of the predictive factors of contraindicated drug prescriptions in patients with CKD in a general practice setting. To the best of our knowledge, a previous study specifically identified the predictors of NSAIDs use and only recently did a few studies focusing on inappropriate drug prescriptions in patients followed by nephrologists become available [20,23,24,26,27].…”

Section: Discussionmentioning

confidence: 99%

“…An increased number of prescriptions was found with an increased stage of CKD (G3a-G5): G3a: 113 (60-187); G3b: 152 (91-229); G4/G5: 196 (117-65), as well as the number of different active substances prescribed: G3a: 18 (12-25); G3b: 22 (15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29); G4/G5: 25 (20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33). The frequency of comorbidities stratified by the severity of CKD are shown in Supplementary Table S2.…”

Section: Characteristics Of Patientsmentioning

confidence: 99%

“…Therefore, polytherapy could lead to greater difficulties in pharmacological management and the inappropriate prescribing of contraindicated medications could result in the worsening and progression of CKD [18]. Renin-angiotensin-system (RAS) blocking agents, beta-blockers, antibiotics, lithium, analgesics, nonsteroidal anti-inflammatory drugs (NSAIDs), anticoagulants, hypoglycemic, and some chemotherapeutic agents are known to be nephrotoxic drugs [19][20][21]. Moreover, NSAIDs result as the most commonly prescribed nephrotoxic drugs in CKD patients [22].…”

Section: Introductionmentioning

confidence: 99%

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Chronic Kidney Disease Management in General Practice: A Focus on Inappropriate Drugs Prescriptions

Rottura

Cicala

Mandraffino³

et al. 2020

JCM

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Nephrotoxic drugs prescriptions are often prescribed inappropriately by general practitioners (GPs), increasing the risk of chronic kidney disease (CKD). The aim of this study was to detect inappropriate prescriptions in patients with CKD and to identify their predictive factors. A retrospective study on patients with creatinine values recorded in the period 2014–2016 followed by 10 GPs was performed. The estimated glomerular filtration rate (eGFR) was used to identify CKD patients. The demographic and clinical characteristics and drugs prescriptions were collected. A descriptive analysis was conducted to compare the characteristics and logistic regression models to estimate the predictive factors of inappropriate prescriptions. Of 4098 patients with creatinine values recorded, 21.9% had an eGFR <60 mL/min/1.73 m2. Further, 56.8% received inappropriate prescriptions, with a significantly lower probability in subjects with at least a nephrologist visit (Adj OR 0.54 (95% CI 0.36–0.81)) and a greater probability in patients treated with more active substances (1.10 (1.08–1.12)), affected by more comorbidities (1.14 (1.06–1.230)), or with serious CKD (G4/G5 21.28 (7.36–61.57)). Nonsteroidal anti-inflammatory drugs (NSAIDs) were the most used contraindicated drugs (48.5%), while acetylsalicylic acid was the most inappropriately prescribed (39.5%). Our results highlight the inappropriate prescriptions for CKD authorized by GPs and underline the need of strategies to improve prescribing patterns.

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Section: Discussioncontrasting

confidence: 94%

Section: Discussionmentioning

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Section: Characteristics Of Patientsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Chronic Kidney Disease Management in General Practice: A Focus on Inappropriate Drugs Prescriptions

Rottura

Cicala

Mandraffino³

et al. 2020

JCM

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Clinical pharmacist as a member of the multidisciplinary kidney care team in low‐ and middle‐income countries: An opportunity to reduce the incidence of drug‐related problems

Okoro

2021

J Am Coll Clin Pharm

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The multiple comorbidities, complications, and polypharmacy coupled with pharmacokinetic and pharmacodynamics changes linked to chronic kidney disease (CKD) predispose patients with this disease to a huge number of drug-related problems (DRPs).Evidence has shown that a clinical pharmacist (CP) is an integral member of the multidisciplinary kidney care team in most high-income countries (HICs). In the team, CP provides patient-centered care, including detection, prevention, and resolution of DRPs, and helping patients overcome challenges to improve drug adherence. Pharmaceutical care in CKD has demonstrated positive economic, clinical, and humanistic outcomes including reduced DRPs, all-cause hospital admission, length of hospital stays, the incidence of end-stage renal disease, and mortality, improved drug knowledge, adherence, health-related quality of life among others. The purpose of this article is to highlight the gaps in drug-related care for patients with CKD in low-and middle-income countries (LMICs), demonstrate that clinical pharmacy services have the capacity to reduce these gaps, identify barriers that hinder its implementation in LMICs and offer recommendations capable of mitigating the identified barriers.

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Novel insights into the potential mechanisms underlying carbendazim‐induced hepatorenal toxicity in rats

Ebedy

El-Shazly

Hassan

et al. 2022

J Biochem & Molecular Tox

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Carbendazim (CBZ) is a common environmental pollutant that can contaminate food and water and severely damage human health. Some studies revealed the adverse effect of CBZ on different organs, but its detailed toxicity mechanism has not been elucidated yet. Thus, the present study aims to clarify the mechanisms of CBZinduced hepatorenal toxicity in rats. Therefore, we partitioned 40 male Wistar rats into four groups (n = 10): a negative control group and three treatment groups, which received 100, 300, and 600 mg/kg of CBZ. All rats received the treatment daily by oral gavage. We collected blood and organ samples (liver and kidney) at 14 and 28 days postdosing. CBZ caused extensive pathological alterations in both the liver and kidneys, such as cellular degeneration and necrosis accompanied by severe inflammatory reactions in a dose-and time-dependent manner. All the CBZ-treated groups displayed strong tumor necrosis factor-α and nuclear factor-κB (NF-κB) immunopositivity. Additionally, CBZ dose-dependently elevated the alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, urea, and creatinine serum levels and reduced the serum albumin levels. Furthermore, CBZ-induced apoptosis, as indicated by the observed Bax gene upregulation and Bcl-2 gene downregulation in both organs. All these changes may be related to oxidative stress, as indicated by the increase in malondialdehyde levels and the decrease in total antioxidant capacity. Our results demonstrate that CBZ-induced dose-and time-dependent hepatorenal damage through oxidative stress, which activated both the NF-κB signaling pathway and Bcl-based programmed cell death.

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The use of nephrotoxic drugs in patients with chronic kidney disease

Cited by 36 publications

References 31 publications

Chronic Kidney Disease Management in General Practice: A Focus on Inappropriate Drugs Prescriptions

Chronic Kidney Disease Management in General Practice: A Focus on Inappropriate Drugs Prescriptions

Clinical pharmacist as a member of the multidisciplinary kidney care team in low‐ and middle‐income countries: An opportunity to reduce the incidence of drug‐related problems

Novel insights into the potential mechanisms underlying carbendazim‐induced hepatorenal toxicity in rats

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