Nephrotoxic medication exposure was the only risk factor significantly associated with initiation of renal replacement therapy (RRT) for acute kidney injury (AKI) in a single-center study of adult patients who had AKI at hospital admission or during a hospital stay, according to a poster presentation at the National Kidney Foundation’s 2022 Spring Clinical Meetings in Boston, Massachusetts.

Exposure to nephrotoxic medication “could be a target for quality improvement,” investigators concluded.

The retrospective observational study, by Si Yuan Khor, MD, of Michigan State University in East Lansing, and colleagues, also identified increasing age as the only risk factor significantly associated with mortality.

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Dr Khor’s group studied 156 patients with AKI at a community-based tertiary care center. Of these, 125 (80.1%) presented with AKI at admission and 31 (19.9%) experienced AKI during their hospital stay. They defined AKI according to Kidney Disease: Improving Global Outcomes (KDIGO) guidelines.

Patients had a median age of 70 years (range 26-100 years) and median length of stay of 6 days. Of the 156 patients, 60.3% had diabetes and 68.6% had exposure to nephrotoxic drugs. RRT was initiated in 12 patients (7.7%) and 11 patients (7.1%) died.

Nephrotoxic medication use was significantly associated with estimated 6.9-fold increased odds of RRT initiation compared with nonuse, according to the investigators. Each 1-year increase in age was significantly associated with an 8% increased risk for death.

“Our findings may have implications for the design of a prediction model for the need for RRT for inpatients with AKI,” the investigators wrote.


Khor SY, WWang L, Hernandez Garcilazo NH, Hassanein M, Laird-Fick H. Risk factors and outcomes of acute kidney injury: A retrospective, observational single center experience. Presented at the National Kidney Foundation’s 2022 Spring Clinical Meetings, Boston, Massachusetts, April 6-10, 2022. Poster 9.