Macaulay Amechi Onuigbo
1*, Eileen Samuel
2, Nneoma Agbasi
31 Mayo Clinic College of Medicine, Rochester, MN, USA
2 Department of Nephrology, Mayo Clinic Health System, Eau Claire, WI, USA
3 North East London NHS Foundation Trust, UK
Abstract
The frequency of hospital-acquired acute kidney injury has been increasing in recent years.
It is associated with higher patient mortality, increased length of stay, increased cost of
hospitalization and potentially is linked with an increased risk of developing chronic kidney
disease and end-stage renal disease over time. Decreased renal perfusion, nephrotoxic
medications, surgery, and radiographic contrast media remain the most common causes of
hospital-acquired acute kidney injury. We present some recent cases of hospital-acquired
acute kidney injury managed in the Renal Unit, Mayo Clinic Health System, Eau Claire, WI,
USA and make a strong case for more preventative nephrology practices to mitigate, if not
eliminate, the scourge of hospital-acquired acute kidney injury.
Implication for health policy/practice/research/medical education:
The increasing incidence of hospital-acquired acute kidney injury remains a challenge to the practicing nephrologist with increasing patient morbidity and mortality, as well as escalating healthcare costs. Preventable causative factors such as decreased renal perfusion, exposure to nephrotoxic mediations and iodinated radiographic contrast, and surgery especially the neglected role of intraoperative hypotension were identified. A strong preventative nephrology paradigm could potentially limit, if not totally eliminate, hospital-acquired acute kidney injury. This imperative is even more mandatory in resource-poor countries and communities.
Please cite this paper as: Onuigbo MA, Samuel E, Agbasi N. Hospital-acquired nephrotoxic exposures in the precipitation
of acute kidney injury – A case series analysis and a call for more preventative nephrology practices. J Nephropharmacol.
2017;6(2):90-97. DOI: 10.15171/npj.2017.11.