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OBJECTIVE：To study the research status ，hotspots and frontier cha nges of drug-induced kidney injury （DIKI）， and to provide reference for the research of DIKI in China. METHODS ：Literatures related to DIKI published from 2001 to 2020 were retrieved from Web of Science database. CiteSpace 5.7.R2 software was used to conduct visualization analysis for DIKI related literatures from aspects of the number of publications ，authors and cited authors ，institutions，countries，related disciplines ， co-cited journals ，co-cited literatures and keywords. RESULTS ：A total of 1 320 literatures were included ，and the number of published literatures about DIKI researches showed an upward trend during 2001-2020. The most studies and the highest co-citations were devoted by the Yale University scholar Mark A Perazella （18 literatures，cited for 137 times）. There were 76 countries carrying out research in this field ，among which the United States had the first advantage （445 literatures，accounting for 34.29％ of the total number of literatures ）. A total of 2 175 institutions participated in this field ，of which Yale University contributed the most publications ；pharmacology，nephrology，toxicology and other related disciplines were involved in this field ；Kidney International（652 literatures，USA）published the most research in this field ；the most frequently cited literature was “Drug- induced nephrotoxicity ：clinical impact and preclinical in vitro models ”，published by Tiong et al in 2014. Through the keyword cluster analysis ，the research hotspots in this field mainly focused on the risk factors of DIKI ，the research of DIKI in special groups，the mechanism of DIKI related drugs ，the exploration of DIKI biomarkers ，and the preclinical research of DIKI. CONCLUSIONS：DIKI’s research has been paid more and more attention by scholars ，but the cooperation between China and other countries in this field is limited. In the future ，more attention should be paid to the research hotspot in this field and international exchanges and cooperation should be strengthened.
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Objective: To analyze the correlation between HD-MTX blood concentration and acute drug-induced liver and kidney injury in the patients with osteosarcoma, and investigate the significance of HD-MTX concentration in the monitoring of liver and kidney toxicity. Methods: A total of 56 osteosarcoma patients treated with HD-MTX were selected, and after HD-MTX treatment, the blood concentration of MTX was detected by an HPLC-UV method in 48 h and 72 h after the administration. The liver and kidney function were measured at the same time. The correlation between the different concentrations of MTX and the change of liver and kidney func-tion was analyzed. Results: All the patients were monitored MTX blood concentration at different time points. After the 48-hour HD-MTX treatment, 4 patients (7. 14% ) were with acute drug-induced liver injury and 13 patients (23. 21% ) showed drug-induced kid-ney injury. The average C48hof liver injury was (2.90 ±0.78) μmol·L-1, and the average C48hof kidney injury was (1.65 ±1.12) μmol·L-1. After the 72-hour HD-MTX treatment, 7 patients ( 12. 50% ) were with drug-induced liver injury and 16 patients (28.57%) showed drug-induced kidney injury. The average C72hof liver injury was (0.30 ±0.17) μmol·L-1, while the average C48hof kidney injury was (0. 29 ± 0. 29) μmol·L-1. The function indices of liver ( ALT, ALP and TBIL) and kidney ( SCr) were significantly higher than those in the normal group (P<0. 05), and the blood concentration of MTX was partly significantly correlated with those indicators. Conclusion: There is a certain correlation between MTX induced injury and the blood drug concentration at par-ticular points, and C48hmay be more valuable to predict drug-induced liver and kidney injury.
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Objective:To analyze the correlation between cyclosporin A blood concentration and drug-induced liver and kidney in-jury in the patients with aplastic anemia, investigate the significance of cyclosporin A concentration in the monitoring of liver and kidney toxicity, and provide theoretical basis for clinical individualized drug use. Methods:A total of 149 patients with aplastic anemia trea-ted with cyclosporin A as the main therapeutic drug were selected, and after 3-day treatment, the blood concentration of cyclosporin A was detected by an HPLC-UV method 10 minutes before the administration and 2 hours after the administration. The liver and kidney function were measured at the same time. The correlation between the different concentration of cyclosporine A and the change of liver and kidney function was analyzed. Results:All the patients were monitored cyclosporine A blood concentration with 1236 samples, and 34 patients (22. 82%) were with drug-induced liver injury and 51 patients (34. 23%) showed drug-induced kidney toxicity. The average C0 of liver injury patients was (297. 92 ± 74. 14) μg·L-1 , and C2 was (944. 47 ± 148. 47) μg·L-1 , while the average C0 of kidney injury patients was (311. 41 ± 52. 80)μg·L-1, and C2 was (926. 25 ± 136. 02) μg·L-1. The function indices of liver (ALT, AST, TBIL) and kidney (SC, BUN, UA) were significantly higher than those in the normal group (P<0. 05), and the blood concentration of cyclosporin A was significantly correlated with the liver,and kidney function. Conclusion:There is a certain correla-tion between cyclosporine A -induced toxicity and its blood concentration and C2 may be a more valuable predictor for drug -induced liver injury.
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Objective:To discuss the ways to deal with adverse drug reactions in pharmaceutical care. Methods:A case of drug-induced kidney injury was provided to analyze the effect of clinical pharmacist on adverse drug reactions. Results and Conclusion:Good quality of pharmaceutical care, such as reliable drug information, is valuable in clinical practice.