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
Objective: To provide some experience and help for the pharmaceutical care for drug-induced acute kidney injury through analysis and pharmaceutical care performed by clinical pharmacist for two cases of drug-induced acute kidney injury. Meth-ods:Clinical pharmacist analyzed the mechanism of drug-induced acute kidney injury, provided some suggestions for the medication, helped doctors select hormone drugs reasonably and performed medical education in the patients. Results:The kidney function of the two patients was recovered during the hospitalization after the reasonable treatment and care by doctors and pharmacists. Conclusion:The drug-induced acute kidney injury should be paid high attention, and the medical education should be strengthened in the patients.