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Expert Consensus on the Nephrotoxic Potential of 195 Medications in the Non-intensive Care Setting: A Modified Delphi Method.
- Source :
-
Drug Safety . Jul2023, Vol. 46 Issue 7, p677-687. 11p. - Publication Year :
- 2023
-
Abstract
- Introduction: Nephrotoxin exposure is significantly associated with acute kidney injury (AKI) development. A standardized list of nephrotoxic medications to surveil and their perceived nephrotoxic potential (NxP) does not exist for non-critically ill patients. Objective: This study generated consensus on the nephrotoxic effect of 195 medications used in the non-intensive care setting. Methods: Potentially nephrotoxic medications were identified through a comprehensive literature search, and 29 participants with nephrology or pharmacist expertise were identified. The primary outcome was NxP by consensus. Participants rated each drug on a scale of 0–3 (not nephrotoxic to definite nephrotoxicity). Group consensus was met if ≥ 75% of responses were one single rating or a combination of two consecutive ratings. If ≥ 50% of responses indicated "unknown" or not used in the non-intensive care setting, the medication was removed for consideration. Medications not meeting consensus for a given round were included in the subsequent round(s). Results: A total of 191 medications were identified in the literature, with 4 medications added after the first round from participants' recommendations. NxP index rating consensus after three rounds was: 14 (7.2%) no NxP in almost all situations (rating 0); 62 (31.8%) unlikely/possibly nephrotoxic (rating 0.5); 21 (10.8%) possibly nephrotoxic (rating 1); 49 (25.1%) possibly/probably nephrotoxic (rating 1.5); 2 (1.0%) probably nephrotoxic (rating 2); 8 (4.1%) probably/definite nephrotoxic (rating 2.5); 0 (0.0%) definitely nephrotoxic (rating 3); and 39 (20.0%) medications were removed from consideration. Conclusions: NxP index rating provides clinical consensus on perceived nephrotoxic medications in the non-intensive care setting and homogeneity for future clinical evaluations and research. [ABSTRACT FROM AUTHOR]
- Subjects :
- *DELPHI method
*ACUTE kidney failure
*DRUGS
Subjects
Details
- Language :
- English
- ISSN :
- 01145916
- Volume :
- 46
- Issue :
- 7
- Database :
- Academic Search Index
- Journal :
- Drug Safety
- Publication Type :
- Academic Journal
- Accession number :
- 164397112
- Full Text :
- https://doi.org/10.1007/s40264-023-01312-5