The spectrum of adverse drug reactions in a multidisciplinary kidney clinic
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.
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.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution-NonCommercial 3.0 Unported License. that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (SeeÂ The Effect of Open Access).