The spectrum of adverse drug reactions in a multidisciplinary kidney clinic

  • Shaima Al-Bader Asad Al-Hamad dermatology center, Ministry of health, Kuwait
  • Shaikha Al-Bader Department of Medicine, Kidney unit, Al-Amiri Hospital, Ministry of health, Kuwait
  • Kamel El-Reshaid Department of Medicine, Faculty of Medicine, Kuwait University, Kuwait

Abstract

Introduction: Data on adverse drug-reactions (ADR) in the medical field are rare. Objective: To report on the pattern of such problem in a multidisciplinary kidney clinic Patients and Methods: Medical records of patients were reviewed retrospectively for such phenomenon in the past 6 years Results: A total of 4834 patients were included for analysis.   The unit is responsible for a large proportion of patients with acute and chronic kidney diseases of diverse etiologies and multiple co-morbid conditions.  Acute and maintenance dialysis as well as immunosuppressive treatment for idiopathic glomerulopathy and autoimmune systemic diseases were common practice.  Results: A total of 70044 ADR were diagnosed in 4438 patients.  Most patients were adults (39+14) and had median follow up of 38 months. Nearly half of the ADR were due to drug-side effects while idiosyncrasy accounted for 1.2%.  The former is due to misuse/abuse of medications while the latter is due to genetic, co-morbid conditions or synergetic between 2 drugs or a drug and disease.  Details of drugs ADR are outlined with their respective prevalence.  Our study indicates the need for careful auditing of patient’s response during follow up to improve their drug-compliance.


Keywords: adverse drug reaction, allergy, medical clinic, kidney disease.

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Author Biographies

Shaima Al-Bader, Asad Al-Hamad dermatology center, Ministry of health, Kuwait

Asad Al-Hamad dermatology center, Ministry of health, Kuwait

Shaikha Al-Bader, Department of Medicine, Kidney unit, Al-Amiri Hospital, Ministry of health, Kuwait

Department of Medicine, Kidney unit, Al-Amiri Hospital, Ministry of health, Kuwait

Kamel El-Reshaid, Department of Medicine, Faculty of Medicine, Kuwait University, Kuwait

Department of Medicine, Faculty of Medicine, Kuwait University, Kuwait

References

1- Lazarou J, Pomperanz BH, Corey PN. Incidence of adverse drug reactions in hospitalized patients. A meta-analysis of prospective studies. JAMA 1998; 279:1200-1205.
2- Thong BY, Tan TC. Epidemiology and risk factors for drug allergy. Br J Clin Pharmacol 2011; 71:684-700.
3- Al-Ahmad M, Rodrigues-Bouza T. Pattern of inpatient referrals to a drug allergy unit in Kuwait. Eur Ann Allergy Clin Immunol 2017; 49:276-280.
4- Johansson SG, Bieber T, Dahl R, Friedmann PS, Lanier BQ, Lockey RF, et al. Revised nomenclature for allergy for global use: Report of the Nomenclature Review Committee of the World Allergy Organization, October 2003. J Allergy Clin Immunol 2004; 113:832–836.
5- El-Reshaid K, Kapoor M, Johny KV and Sugathan TN. Acute renal failure in Kuwait, a prospective study. J Trop Med Hygiene 1993; 96:323-329.
6- Muller PY, Milton MN. "The determination and interpretation of the therapeutic index in drug development". Nature Reviews. Drug Discovery 2012; 11:751–61.
7- Dixit M, Doan T, Kirschner R, Dixit N. Significant kidney injury due to non-steroidal anti-inflammatory drugs: Inpatient setting. Pharmaceuticals 2010; 3:1279-1285.
8- Jentzer JC, Dewald TA, Hernandez AF. Combination of loop diuretics with thiazide-type diuretics in heart failure. JACC 2010; 56:1527-1534.
9- Sinha AD, Agawal R. Thiazide diuretics in chronic kidney disease. Curr Hypertens Rep 2015; 17:1-6.
10- Pitt B, Pierard LA, Bilge A et al. Effectiveness of spironolactone added to an angiotensin-converting enzyme inhibitor and a loop diuretic for severe chronic congestive heart failure (The Randomized Aldosterone Evaluation Study (RALES). Am J Cardiol. 1996; 78:902-907.
11- James PA, Oparil S, Carter BL, Cushman WC, Dennison-Himmelfarb C, Handler J, et al. 2014 evidence-based guideline for the management of high blood pressure in adults: Report from the panel members appointed to the Eighth Joint National Committee (JNC 8) JAMA. 2014; 311:507–20.
12- Omer HM, Hodson J, Thomas SK, Coleman JJ. Multiple drug intolerance syndromes: a large-scale retrospective study. Drug Saf 2014; 37:1037-45.
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How to Cite
Al-Bader, S., Al-Bader, S., & El-Reshaid, K. (2019). The spectrum of adverse drug reactions in a multidisciplinary kidney clinic. Journal of Drug Delivery and Therapeutics, 9(1), 61-67. https://doi.org/10.22270/jddt.v9i1.2160