Phenotype standardization for drug-induced kidney disease.
Phenotype standardization for drug-induced kidney disease.
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DOI：
10.1038/ki.2015.115
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发表时间：
2015-08
影响因子：
19.6
通讯作者：
Goldstein SL
中科院分区：
文献类型：
--
作者：
Mehta RL;Awdishu L;Davenport A;Murray PT;Macedo E;Cerda J;Chakaravarthi R;Holden AL;Goldstein SL
药物性肾病是肾功能不全的常见原因;然而，没有标准来识别和表征这些疾病的谱。我们召集了一个由国际、成人和儿童、肾病学家和药剂师组成的专家组，以开发药物性肾病的标准化表型，作为国际严重不良事件联盟发起的表型标准化项目的一部分。我们根据临床表现提出了药物性肾脏疾病的四种表型：急性肾损伤、肾小球、肾小管和肾结石，沿着支持表型定义的主要和次要临床标准，以及基于KDIGO/AKIN定义的急性肾损伤、急性肾脏疾病和慢性肾脏疾病的时间进程。确定药物性肾病的因果关系具有挑战性，需要了解特定药物的生物相容性、损伤机制、时间过程和竞争风险因素的评估。这些表型为临床医生、研究者、行业和监管机构提供了一个一致的框架，以评估各种环境下的药物肾毒性。我们相信，这是认识药物性肾病和制定预防和管理这种疾病的策略的第一步。
Drug induced kidney disease is a frequent cause of renal dysfunction; however, there are no standards to identify and characterize the spectrum of these disorders. We convened a panel of international, adult and pediatric, nephrologists and pharmacists to develop standardized phenotypes for drug induced kidney disease as part of the phenotype standardization project initiated by the International Serious Adverse Events Consortium. We propose four phenotypes of drug induced kidney disease based on clinical presentation: acute kidney injury, glomerular, tubular and nephrolithiasis, along with primary and secondary clinical criteria to support the phenotype definition, and a time course based on the KDIGO/AKIN definitions of acute kidney injury, acute kidney disease and chronic kidney disease. Establishing causality in drug induced kidney disease is challenging and requires knowledge of the biological plausibility for the specific drug, mechanism of injury, time course and assessment of competing risk factors. These phenotypes provide a consistent framework for clinicians, investigators, industry and regulatory agencies to evaluate drug nephrotoxicity across various settings. We believe that this is first step to recognizing drug induced kidney disease and developing strategies to prevent and manage this condition.