Sravani Madhileti, Krishnamurthy Sriram, Parameswaran Narayanan, Rajappa Medha
Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry.
Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry. Correspondence to: Dr Sriram Krishnamurthy, Professor, Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry 605 006.
Indian Pediatr. 2022 Mar 15;59(3):226-229. Epub 2022 Jan 5.
To evaluate the incidence of aminoglycoside-related nephrotoxicity and ascertain drug causality and its risk factors.
This prospective study was conducted from January, 2019 to January, 2021, and recruited 110 consecutively admitted children aged 1 month to 12 years, receiving aminoglycosides for ≥4 days. Drug causality was assessed using Liverpool adverse drug reaction causality assessment tool.
42 (38.2%) children developed acute kidney injury (AKI), with 71 (64.5%) having composite nephrotoxicity (AKI and/or tubular-dysfunction). Only 17 (15.5%) had AKI definitively attributable to aminoglycosides. Hypotension [OR 0.016 (95% CI 0.01-0.71), P=0.03], PRISM-III score 20-29% [OR 55.48 (95% CI 3.66-840.53), P=0.004] and post-surgery patients [OR 3.2 (95% CI 1.01-10.1), P=0.047] were independent predictors of AKI.
Only a small proportion of children receiving aminoglycosides had AKI definitively attributable to the drug.
评估氨基糖苷类药物相关肾毒性的发生率，确定药物因果关系及其危险因素。
本前瞻性研究于2019年1月至2021年1月进行，纳入110例年龄在1个月至12岁之间、连续入院且接受氨基糖苷类药物治疗≥4天的儿童。使用利物浦药物不良反应因果关系评估工具评估药物因果关系。
42例（38.2%）儿童发生急性肾损伤（AKI），其中71例（64.5%）出现复合性肾毒性（AKI和/或肾小管功能障碍）。只有17例（15.5%）的AKI明确归因于氨基糖苷类药物。低血压[比值比（OR）0.016（95%置信区间0.01 - 0.71），P = 0.03]、小儿死亡风险评分（PRISM - III）20 - 29%[OR 55.48（95%置信区间3.66 - 840.53），P = 0.004]和术后患者[OR 3.2（95%置信区间1.01 - 10.1），P = 0.047]是AKI的独立预测因素。
接受氨基糖苷类药物治疗的儿童中，只有一小部分的AKI明确归因于该药物。
