Determining the insidence of drug-induced AKI in children admitted to PICU a cross sectional study

Abstract

Introduction: Acute kidney injury (AKI) can have significant consequences in the clinical management of hospitalized patients. Identifying drugs responsible for AKI may lead to the use of safer pharmacologic alternatives in patient care.Objective: To evaluate the incidence of drug-induced AKI in children admitted to the Pediatric Intensive Care Unit (PICU): a prospective observational cross-sectional study.Methods: This was an observational cross-sectional study conducted on children admitted to the PICU of Zahra Mardani Azar Children’s Hospital in Tabriz during the year 2022 (1401 in the Iranian calendar) over a 12-month period. Data sources included the patients’ medication charts, medical records, and nursing notes. Patient information was extracted from the medical records, and all administered medications were comprehensively documented.Results: The incidence of AKI among children admitted to the PICU was 13 patients (6.3%). Of these, 4 cases (30.76%) were diagnosed with drug-induced AKI, and 9 cases (69.23%) with non-drug-related AKI. Analysis of prescribed medications revealed a statistically significant difference between the AKI and non-AKI groups with regard to certain drugs. Notably, iodinated contrast media (P < 0.0001), antiviral agents (P < 0.0001), furosemide (P < 0.0001), and ceftriaxone (P = 0.018) were significantly associated with the development of AKI.Conclusion: The incidence of acute kidney injury (AKI) among children admitted to the PICU was 6.3%. Of these, 30.76% were drug-induced AKI cases, while 69.23% were non-drug-related. The study highlights that certain medications, particularly iodinated contrast agents, antiviral drugs, furosemide, and ceftriaxone, are significantly associated with the occurrence of AKI in pediatric patients. These findings underscore the importance of cautious prescription and monitoring of nephrotoxic agents in critically ill children.