Background: Drug-induced acute kidney injury is a common situation in clinical\npractice. Many treatments are involved and they are even more aggressive when associated\nwith a predisposing factor such as diabetes. We aimed to investigate clinical\nfeatures of acute drug-induced kidney injury in diabetics in order to clarify renal\nprognosis. Methods: This was a descriptive and analytical retrospective study including\ndiabetics who presented drug-induced acute kidney injury, conducted in our\ndepartment during the period from 1986 to 2015. Acute kidney injury was classified\naccording to Kidney Disease Improving Global Outcomes criteria. We analyzed medical\nrecords of patients. Results: 31 patients were included with mean age of 65.41\nyears and gender ratio M/F at 0.93. Diabetes was type 2 in 97% of cases. Mean previous\ncreatinine clearance was 39.33 ml/min/1.73 m2. Drugs involved were blockers\nof renin-angiotensin system (35%), aminoglycosides (16%), non-steroidal anti-inflammatory\n(16%), diuretics (13%), lipid-lowering agents (10%), rifampicin (6%) and\nifosfamide (3%). Extracellular dehydration was present in nine cases (29%). Main\ndrug combinations were with diuretics in 16 cases (52%) and with ACE inhibitor or\nARB in eight cases (26%). Oligo anuria was observed in 5 cases (16%). Proteinuria\nwith urine strips was objectified in 25 cases (81%). Acute kidney injury was grade 3\nin 24 cases (77%), grade 2 in three cases (10%) and grade 1 in four cases (13%). Renal\nsurvival at 102 months was 57%. Identified renal prognosis factors were serum phosphorus\n>1.47 mmol/l (p = 0.01), proteinuria at urine strips (p = 0.042), dehydration\n(p = 0.013), oral antidiabetic treatment (p = 0.038), intravenous rehydration (p =\n0.021) and insulin (p = 0.006). Conclusion: Drug-induced acute kidney injury is potentially\nserious in diabetics. Prevention is essential to improve the prognosis of this\nrenal damage.
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