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Kidney Function Decline and Serious Adverse Drug Reactions in Patients With CKD

dc.rights.licenseopenen_US
dc.contributor.authorLAVILLE, Solène M.
dc.contributor.authorGRAS-CHAMPEL, Valérie
dc.contributor.authorHAMROUN, Aghilès
dc.contributor.authorMORAGNY, Julien
dc.contributor.authorLAMBERT, Oriane
dc.contributor.authorMETZGER, Marie
dc.contributor.authorJACQUELINET, Christian
hal.structure.identifierBioingénierie tissulaire [BIOTIS]
dc.contributor.authorCOMBE, Christian
dc.contributor.authorFOUQUE, Denis
dc.contributor.authorLAVILLE, Maurice
dc.contributor.authorFRIMAT, Luc
dc.contributor.authorROBINSON, Bruce M.
dc.contributor.authorBIEBER, Brian
dc.contributor.authorSTENGEL, Bénédicte
dc.contributor.authorALENCAR DE PINHO, Natalia
dc.contributor.authorMASSY, Ziad A.
dc.contributor.authorLIABEUF, Sophie
dc.contributor.authorAYAV, Carole
dc.contributor.authorBRIANÇON, Serge
dc.contributor.authorCANNET, Dorothée
dc.contributor.authorHERPE, Yves-Edouard
dc.contributor.authorPASCAL, Christophe
dc.contributor.authorLANGE, Céline
dc.contributor.authorLEGRAND, Karine
dc.contributor.authorSPEYER, Elodie
dc.contributor.authorHANNEDOUCHE, Thierry
dc.contributor.authorMOULIN, Bruno
dc.contributor.authorMAILLIEZ, Sébastien
dc.contributor.authorLEBRUN, Gaétan
dc.contributor.authorMAGNANT, Eric
dc.contributor.authorCHOUKROUN, Gabriel
dc.contributor.authorDEROURE, Benjamin
dc.contributor.authorLACRAZ, Adeline
dc.contributor.authorLAMBREY, Guy
dc.contributor.authorPHILIPPE, Jean
dc.contributor.authorBOURDENX
dc.contributor.authorESSIG, Marie
dc.contributor.authorLOBBEDEZ, Thierry
dc.contributor.authorAZAR, Raymond
dc.contributor.authorSEKHRI, Hacène
dc.contributor.authorSMATI, Mustafa
dc.contributor.authorJAMALI, Mohamed
dc.contributor.authorKLEIN, Alexandre
dc.contributor.authorDELAHOUSSE, Michel
dc.contributor.authorMARTIN, Séverine
dc.contributor.authorLANDRU, Isabelle
dc.contributor.authorTHERVET, Eric
dc.contributor.authorLANG, Philippe
dc.contributor.authorBELENFANT, Xavier
dc.contributor.authorURENA, Pablo
dc.contributor.authorVELA, Carlos
dc.contributor.authorCHAUVEAU, Dominique
dc.contributor.authorPANESCU, Viktor
dc.contributor.authorNOEL, Christian
dc.contributor.authorGLOWACKI, François
dc.contributor.authorHOFFMANN, Maxime
dc.contributor.authorHOURMANT, Maryvonne
dc.contributor.authorBESNIER, Dominique
dc.contributor.authorTESTA, Angelo
dc.contributor.authorKUENTZ, François
dc.contributor.authorZAOUI, Philippe
dc.contributor.authorCHAZOT, Charles
dc.contributor.authorJUILLARD, Laurent
dc.contributor.authorBURTEY, Stéphane
dc.contributor.authorKELLER, Adrien
dc.contributor.authorKAMAR, Nassim
dc.date.accessioned2025-03-26T13:14:12Z
dc.date.available2025-03-26T13:14:12Z
dc.date.issued2024-05
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/205694
dc.description.abstractEnRationale & Objective: Adverse drug reactions (ADRs) are common in patients with chronic kidney disease (CKD). The impact of kidney function decline on serious ADR risk has been poorly investigated. We comprehensively describe ADRs and assess the relationship between estimated glomerular filtration rate (eGFR) and serious ADR risk. Study Design: Prospective cohort study. Setting & Participants: 3,033 participants in French Chronic Kidney Disease-Renal Epidemiology and Information Network (CKD-REIN) cohort study, a nationwide sample of nephrology outpatients with moderate to advanced CKD. Predictors: Demographic and biological data (including eGFR), medication prescriptions. Outcome: ADRs (preventable or not) were prospectively identified from hospital discharge reports, medical records, and patient interviews. Expert pharmacologists used validated tools to adjudicate ADRs. Analytical Approach: Restricted cubic splines in fully adjusted cause-specific Cox proportional hazard models were used to evaluate the relationship between eGFR and the risk of serious ADRs (overall and by subtype). Results: During a median follow-up period of 4.7 years, 360 patients experienced 488 serious ADRs. Kidney and urinary disorders (n = 170) and hemorrhage (n = 170) accounted for 70% of serious ADRs. The most common medications classes were antithrombotics and renin-angiotensin system inhibitors. The majority of those serious ADRs were associated with hospitalization (n = 467), with 32 directly or indirectly associated with death and 22 associated with a life-threatening event. More than 27% of the 488 serious ADRs were preventable or potentially preventable. The eGFR is a major risk factor for serious ADRs. The risk of acute kidney injury was 2.2% higher and risk of bleeding ADRs was 8% higher for each 1 mL/min/1.73 m2 lower baseline eGFR. Limitations: The results cannot be extrapolated to patients who are not being treated by a nephrologist. Conclusions: ADRs constitute a major cause of hospitalization in CKD patients for whom lower eGFR level is a major risk factor. Plain-Language Summary: Patients with chronic kidney disease (CKD) have complex clinical presentations, take multiple medications, and often receive inappropriate prescriptions. Using data from a large, prospective CKD cohort, we found a high incidence of serious adverse drug reactions (ADRs). The 2 most common serious ADRs were drug-induced acute kidney injury and bleeding. A large proportion of serious ADRs required hospital admission, and 11% led to death or were life threatening. Lower kidney function was a major risk factor for serious ADRs. Many of these serious ADRs were determined to be partly preventable through greater adherence to prescription guidelines. This report enhances our understanding of the potential toxicity of drugs taken by patients with moderate to advanced CKD. It emphasizes the importance of monitoring kidney function when prescribing drugs, particularly for high-risk medications such as antithrombotic agents. © 2023 The Authors
dc.language.isoENen_US
dc.rightsAttribution-NonCommercial-NoDerivs 3.0 United States*
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/3.0/us/*
dc.subjectAcute kidney injury
dc.subjectadverse drug reaction
dc.subjectbleeding
dc.subjectchronic kidney disease
dc.subjectpharmacoepidemiology
dc.title.enKidney Function Decline and Serious Adverse Drug Reactions in Patients With CKD
dc.typeArticle de revueen_US
dc.identifier.doi10.1053/j.ajkd.2023.09.012en_US
dc.subject.halSciences du Vivant [q-bio]en_US
bordeaux.journalAmerican Journal of Kidney Diseasesen_US
bordeaux.page601 – 614en_US
bordeaux.volume83en_US
bordeaux.hal.laboratoriesBioingénierie Tissulaire (BioTis) - U1026en_US
bordeaux.issue5en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.institutionCNRSen_US
bordeaux.institutionINSERMen_US
bordeaux.institutionCHU de Bordeauxen_US
bordeaux.institutionInstitut Bergoniéen_US
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
hal.popularnonen_US
hal.audienceInternationaleen_US
hal.exportfalse
dc.rights.ccCC BY-NC-NDen_US
bordeaux.COinSctx_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.jtitle=American%20Journal%20of%20Kidney%20Diseases&rft.date=2024-05&rft.volume=83&rft.issue=5&rft.spage=601%20%E2%80%93%20614&rft.epage=601%20%E2%80%93%20614&rft.au=LAVILLE,%20Sol%C3%A8ne%20M.&GRAS-CHAMPEL,%20Val%C3%A9rie&HAMROUN,%20Aghil%C3%A8s&MORAGNY,%20Julien&LAMBERT,%20Oriane&rft.genre=article


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