Drug-induced kidney injury and acute interstitial nephritis

An older ICU patient on vancomycin plus piperacillin-tazobactam develops AKI on day 3. That combination carries significantly higher AKI risk than vancomycin plus cefepime (OR 2.55) or meropenem (OR 2.26) in network meta-analysis — the drug review, not the contrast, comes first.^[8]

The triple whammy and haemodynamic injury

Triple therapy (diuretic plus ACEi/ARB plus NSAID) raised AKI risk (rate ratio 1.31, highest in the first 30 days at 1.82); double therapy with NSAIDs was not associated with increased AKI.^[12] Drugs remain a relatively common cause of acute and chronic kidney injury through patient, kidney and drug factors.^[3]

References16ShowHide

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