ABSTRACT
OBJECTIVE：To study clinical situation and influential factors for prognosis of drug-i nduced acute kidney injury （DIAKI）in Chinese population ，and to provide reference for early detection ，early intervention and prognosis improvement of DIAKI. METHODS ：Retrieved from PubMed ，Embase，Cochrane Library ，CNKI，Wanfang database and VIP ，clinical studies related to DIAKI were collected during the inception to Apr. 16th，2020. After the data extraction and quality evaluation of included studies，the results were analyzed descriptively ，and Meta-analysis was carried out by Rev Man 5.3 software. RESULTS ：A total of 29 studies were included ，including 1 870 patients. The results showed that DIAKI accounted for 32.2％（877/2 721）of the patients developed AKI in the same period. Antibacterial drugs were the main cause of DIAKI ，accounting for 47.5％（773/1 629）. The top five drugs by case number were classified as aminoglycoside antibiotics ，diuretics or dehydrating agents ，cephalosporin antibiotics，non-steroidal anti-inflammatory drugs and traditional Chinese medicine. The pathological type of DIAKI was mainly acute interstitial nephritis ，accounting for 51.9％（70/135）. The mortality of DIAKI patients was 14.4％（240/1 677）. A total of 70.4％（1 176/1 670）of patients had renal recovery. Compared with conservative treatment ，the mortality of patients receiving dialysis treatment was significantly lower [OR ＝0.30，95％CI（0.10，0.91），P＝0.003]. Compared with patients without anemia ， patients with anemia had a significantly delayed renal recovery [OR ＝0.25，95％CI（0.09，0.65），P＝0.004]. Lower levels of retinol binding protein was significantly related to rapid renal recovery [MD ＝－15.84，95％CI（－22.34，－9.34），P＜0.01]. CONCLUSIONS：Clinicians need to continuously strengthen antibiotic management and use drugs that induce AKI with caution. For patients with DIAKI ，receiving dialysis treatment as soon as possible may help reduce mortality. Timely correction of the basic anemia status of patients with DIAKI will help patients withrapid renal recovery ，and lower retinol binding protein levels may be a potential biomarker for predicting patients ’rapidrenal recovery.
ABSTRACT
The National Committee for Quality Assurance(NCQA)and the Pharmacy Quality Alliance(PQA)used the American Geriatrics Society(AGS)Beers Criteria to establish the quality measure system of high-risk medications and potentially harmful drug-disease interactions in the elderly.Medications included may be harmful to elderly adults,and negatively affect health care plans' quality ratings.AGS experts conducted a comprehensive literature review and prepared a list of drug-therapy alternatives with supporting references.NCQA,PQA,the 2015 AGS Beers Criteria panel,and the Executive Committee of the AGS reviewed the drug therapy alternatives and nonpharmacological approaches.Prescribers,pharmacists,patients,and health care plans may benefit from this list.