Adverse drug reactions seen as ‘major cause of hospitalization’ in patients with CKD
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Key takeaways:
- During 4.7 years, 360 patients had 488 serious adverse reactions.
- More than 27% of serious reactions were preventable or potentially preventable.
Adverse drug reactions make up a major cause of hospitalization in patients with chronic kidney disease where lower eGFR is a risk factor, according to published data.
“Drugs provide therapeutic benefits but can also cause adverse drug reactions (ADRs), which range from frequent but nonserious events with mild symptoms to rare, serious events including disability and death,” Solène M. Laville, of the department of clinical pharmacology at the Amiens-Picardie University Medical Center, wrote with colleagues.
Researchers conducted a nationwide prospective cohort study between 2013 and 2016 that included 3,033 nephrology patients in the French CKD-Renal Epidemiology and Information Network. Patients had moderate to advanced CKD, which was defined as an eGFR below 60 mL/min per 1.73 m2, were not on dialysis and had not received a kidney transplant.
Main outcomes were adverse reactions prospectively identified from hospital discharge reports, medical records and patient interviews.
During a median 4.7 years follow-up, 360 patients experienced 488 serious adverse reactions, according to the findings. Kidney and urinary disorders and hemorrhage accounted for 70% of serious ADRs. Medications including antithrombotic agents and renin-angiotensin system inhibitors were commonly associated with adverse events.
Drug-induced AKI and bleeding were the most common adverse reactions, researchers found. A large proportion of serious ADRs required hospitalization, with 32 directly or indirectly linked to death and 22 associated with a life-threatening event.
More than 27% of serious ADRs were preventable or potentially preventable, according to the researchers. “The risk of [AKI] was 2.2% higher and the risk of bleeding ADRs was 8% higher for each 1 mL/min/1.73 m2 lower baseline eGFR,” according to the study. Investigators also underlined lower kidney function as a major risk factor for serious adverse reactions.
“Our results highlight the high burden of serious ADR, show that serious ADRs are a major cause of hospital admission in this population and emphasize the importance of monitoring kidney function over time when prescribing drugs, especially antithrombotic agents,” the researchers wrote. “Greater awareness among clinicians of the heightened risk of ADRs in advanced CKD, more resources directed toward support for patients, and implementation of other pharmaceutical-related risk mitigation strategies should be targeted to improve safety and outcomes in this high-risk population.”
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