Risk Factors and Machine Learning Model for Diuretics Related Acute Kidney Injury

Study Overview
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Brief Summary
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Acute kidney injury (AKI) is a series of clinical syndromes in which serum creatinine (Scr) concentrations increase over a short period of time, or urine output decreases. It has become an increasing global concern.Drug-induced acute kidney injury (D-AKI) refers to kidney injury caused by drugs or their metabolites within 7 days after the use of one or more drugs. The kidneys are rich in blood flow and have the function of acidifying the urine, making them an easy target for drug toxicity. Besides, there are enzymes in the kidney that metabolize some drugs, and if these drugs are metabolized abnormally in the kidney, substances toxic to the kidney may be produced.It was found that about 20% of AKI in hospitalized patients was caused by medications.Diuretics are one of the well-known nephrotoxic drugs, since they can directly or indirectly cause a significant decrease in renal blood perfusion and glomerular filtration rate through the mechanism of affecting tubulobulb feedback, which leads to kidney ischemia and hypoxia.However, there are few real-world studies on the incidence of AKI in hospitalized patients received diuretics. In this study, we aimed to explore the incidence and risk factors analysis of AKI in hospitalized patients received diuretics and develop the machine learning model for diuretics related AKI based on electronic medical record data. With the individual characteristics of patients, the risk of AKI can be evaluated before receiving diuretics, which may provide useful information for clinical decision making to better prevent D-AKI.

Official Title
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Analysis of Risk Factors of Diuretics Related Acute Kidney Injury in Hospitalized Patients and Development of Machine Learning Model

Conditions
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Diuretic Toxicity, Acute Kidney Injury

Intervention / Treatment
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* Other: Diuretics


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All inpatients who used diuretics during hospitalization Hospital stay ≥ 48h Age ≥ 18 years There were two or more blood creatinine tests during hospitalization Exclusion Criteria: Hospital stay < 48h Age < 18 years GFR < 30ml/min/1.73m2 within 48 hours after admission AKI was diagnosed on admission Less than two Scr test results during hospitalization The Scr values were always lower than 40 μmol/L during hospitalization Cases with incomplete medical history information

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 100 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| AKI Group<br> | Other: Diuretics<br>* Inpatients using diuretics<br>|
| Non-AKI Group<br> | Other: Diuretics<br>* Inpatients using diuretics<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Acute kidney injury | During the patient's hospitalization, acute kidney injury occurred after diuretic use. | Through study completion，up to half a year. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Diuretics, Aute kidney injury, Pharmacoepidemiology, Miss diagnosis, Risk factors, Logic regression