Consensus Obtained for the Nephrotoxic Potential of 167 Drugs in Adult Critically Ill Patients Using a Modified Delphi Method.
Consensus Obtained for the Nephrotoxic Potential of 167 Drugs in Adult Critically Ill Patients Using a Modified Delphi Method.
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DOI：
10.1007/s40264-022-01173-4
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发表时间：
2022-04
期刊：
影响因子：
4.2
通讯作者：
Kane-Gill SL
中科院分区：
文献类型：
--
作者：
Gray MP;Barreto EF;Schreier DJ;Kellum JA;Suh K;Kashani KB;Rule AD;Kane-Gill SL
在药物相关急性肾损伤研究中评价肾毒素的方法各不相同。一些研究使用不到10种药物进行评估，而其他研究则包括100多种药物。药物通常被分配一个二元分类，肾毒性或非肾毒性。这过度简化了正在研究的药物的肾毒性潜力。本研究旨在为成人重症监护环境中使用的167种药物分配肾毒性潜力。一个三轮的，国际的，跨学科的，基于网络的改良德尔菲研究被用来评估肾毒素用于成人重症患者。通过急性疾病质量倡议小组和专业协会确定了24名国际经验丰富的临床医生。包括代表重症监护、肾脏病学和药学领域的个人。从文献中确定了159种药物，在第一轮后增加了8种药物，总共167种药物。主要结局是肾毒性评级达成共识。每轮评估评分，以确定是否达成共识。我们的肾毒性潜在指数评级表明，根据共识，20种药物为很可能或很可能/明确的肾毒性。基于重症监护中药物的标准使用和以下共识评分评估肾毒性潜力：0 =无肾毒性潜力，1 =可能的肾毒性潜力，2 =很可能的肾毒性潜力，3 =明确的肾毒性潜力。肾毒素潜力指数评级允许优先考虑具有更大肾毒性潜力的靶向药物，用于机构肾毒素管理计划。此外，肾毒性潜在指数评级为研究提供了同质性，并为每种药物的严重程度详细评估提供了指导。在线版本包含补充材料，可通过10.1007/s40264-022-01173-4获得。
The approach to evaluating nephrotoxins in studies of drug-associated acute kidney injury varies. Some studies use a list of under ten drugs for evaluation whereas others include over 100 drugs. Drugs are typically assigned a binary classification, nephrotoxic or not nephrotoxic. This oversimplifies the nephrotoxic potential of the drugs under investigation. This study aimed to assign a nephrotoxin potential for 167 drugs used in the adult critical care setting. A three-round, international, interdisciplinary, web-based modified-Delphi study was used to evaluate nephrotoxins used in adult critically ill patients. Twenty-four international experienced clinicians were identified through the Acute Disease Quality Initiative group and professional affiliations. Included individuals represented the fields of intensive care, nephrology, and pharmacy. One hundred and fifty-nine medications were identified from the literature, with eight additional medications added after the first round, for a total of 167 medications. The primary outcome was consensus achieved for nephrotoxicity ratings. Scores were evaluated each round to determine if a consensus was met. Our nephrotoxin potential index rating indicated that 20 drugs were nephrotoxicity probable or probable/definite per consensus. Nephrotoxic potential was assessed based on the standard use of medications in intensive care and the following consensus scores: 0 = no nephrotoxic potential, 1 = possible nephrotoxic potential, 2 = probable nephrotoxic potential, 3 = definite nephrotoxic potential. The nephrotoxin potential index rating allows for prioritization of targeted drugs with greater nephrotoxic potential for institutional nephrotoxin stewardship programs. Furthermore, the nephrotoxin potential index rating provides homogeneity for research and guidance on detailed assessments by severity for each drug. The online version contains supplementary material available at 10.1007/s40264-022-01173-4.
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影响因子：
11.8
作者：
Pettit, Natasha N.;Pisano, Jennifer;Mullane, Kathleen M.
通讯作者：
Mullane, Kathleen M.
影响因子：
4.3
作者：
Kane-Gill, Sandra L.;Goldstein, Stuart L.
通讯作者：
Goldstein, Stuart L.
DOI：
10.5863/1551-6776-24.5.416
发表时间：
2019-09-01
期刊：
The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG
影响因子：
--
作者：
Hsu, Alice Jenh;Tamma, Pranita D
通讯作者：
Tamma, Pranita D
影响因子：
120.7
作者：
Futier, Emmanuel;Garot, Matthias;Laclautre, Lise
通讯作者：
Laclautre, Lise
影响因子：
19.6
作者：
Mehta RL;Awdishu L;Davenport A;Murray PT;Macedo E;Cerda J;Chakaravarthi R;Holden AL;Goldstein SL
通讯作者：
Goldstein SL