The Acute Kidney Intervention and Pharmacotherapy (AKIP) List: Standardized List of Medications That Are Renally Eliminated and Nephrotoxic in the Acutely Ill.
Erin F Barreto, Alexis M Gaggani, Brandy N Hernandez, Nabihah Amatullah, Colleen M Culley, Britney Stottlemyer, Raghavan Murugan, Tezcan Ozrazgat-Baslanti, Azra Bihorac, John A Kellum, Kianoush B Kashani, Andrew D Rule, Sandra L Kane-Gill, MEnD-AKI Study Group
Author Information
Erin F Barreto: Department of Pharmacy, Mayo Clinic, Rochester, MN, USA. ORCID
Alexis M Gaggani: Department of Pharmacy and Therapeutics, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, USA.
Brandy N Hernandez: Department of Pharmacy, Mayo Clinic, Rochester, MN, USA.
Nabihah Amatullah: Department of Pharmacy and Therapeutics, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, USA.
Colleen M Culley: Department of Pharmacy and Therapeutics, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, USA.
Britney Stottlemyer: Department of Pharmacy and Therapeutics, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, USA.
Raghavan Murugan: Program for Critical Care Nephrology, Department of Critical Care Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Tezcan Ozrazgat-Baslanti: Intelligent Clinical Care Center, University of Florida, Gainesville, FL, USA.
Azra Bihorac: Intelligent Clinical Care Center, University of Florida, Gainesville, FL, USA.
John A Kellum: Program for Critical Care Nephrology, Department of Critical Care Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Kianoush B Kashani: Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA.
Andrew D Rule: Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA.
Sandra L Kane-Gill: Department of Pharmacy and Therapeutics, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, USA. ORCID
The objective of this project was to develop a standardized list of renally eliminated and potentially nephrotoxic drugs that will help inform initiatives to improve medication safety. Several available lists of medications from the published literature including original research articles and reviews, and from regulatory agencies, tertiary references, and clinical decision support systems were compiled, consolidated, and compared. Only systemically administered medications were included. Medication combinations were included if at least 1 active ingredient was considered renally dosed or potentially nephrotoxic. The medication list was reviewed for completeness and clinical appropriateness by a multidisciplinary team of individuals with expertise in critical care, nephrology, and pharmacy. An initial list of renally dosed and nephrotoxic drugs was created. After reconciliation and consensus from clinical experts, a standardized list of 681 drugs is proposed. The proposed evidence-based standardized list of renally dosed and potentially nephrotoxic drugs will be useful to harmonize epidemiologic and medication quality improvement studies. In addition, the list can be used for clinical purposes with surveillance in nephrotoxin stewardship programs. We suggest an iterative re-evaluation of the list with emerging literature and new medications on an approximately annual basis.
