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Síndromes e Manifestações Renais Associadas ao Uso de Medicamentos
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Abstract(s)
Os medicamentos mudaram o mundo e permitiram aumentar a esperança média de vida, além da qualidade da mesma. No entanto, tal como facas de dois gumes, são fortes indutores de morbimortalidade num contexto onde se integram as reações adversas medicamentosas. Os rins, órgãos depurativos e parte interessada no xenometabolismo, encontram-se extremamente expostos a todas as interações com os medicamentos, pelo que o desenvolvimento de reações adversas medicamentosas com manifestações renais é mais do que esperado. Apesar da abundância de estudos sobre a interação entre medicamentos e rins, não só se constata a dispersão e desorganização das informações existentes, como também se identificam hiatos significativos na informação disponível. Assim, este trabalho visa não apenas consolidar e adicionar novos dados, mas também identificar padrões emergentes e potenciais riscos associados a novas moléculas, proporcionando uma base sólida para futuras intervenções clínicas e políticas de saúde.
Os autores realizaram um trabalho baseado na VigiBase e estruturado em quatro principais clusters de manifestação renal – i) Doença Renal Aguda, ii) Desordens Glomerulares, iii) Nefrolitíase e iv) Desordens Tubulares. As notificações de cada um destes clusters foram filtradas através dos termos MedDRA mais apropriados e, com este planeamento, conseguiu-se, além de estruturar e clarificar os fenótipos renais mais frequentes ou os associados a pior prognóstico, reconhecer também os medicamentos mais envolvidos, os que apresentam maior associação aos diferentes fenótipos, além de identificar um conjunto de moléculas tidas como potenciais novas nefrotoxinas. Deste trabalho, além do acima referido, resulta a necessidade de um maior número de estudos sobre a área, a urgência de educar os diferentes agentes envolvidos na identificação e notificação das diversas
reações adversas, conferir maiores competências e, desta forma, melhorar a segurança do doente ao melhorar a segurança do medicamento.
Medications have transformed the world and have enabled an increase in average life expectancy, as well as its quality. However, like double-edged swords, they are significant contributors to morbidity and mortality within the context of adverse drug reactions. The kidneys, as detoxifying organs and key players in xenometabolism, are exceedingly exposed to all interactions with medications. Therefore, the development of adverse drug reactions with renal manifestations is more than expected. Despite the abundance of studies on the interaction between drugs and the kidneys, there is not only a noticeable dispersion and disorganization of existing information, but also significant gaps identified in the available data. Thus, this work aims not only to consolidate and add new data but also to identify emerging patterns and potential risks associated with new molecules, providing a solid foundation for future clinical interventions and health policies. The authors conducted a study based on VigiBase, structured into four main clusters of renal manifestations: (i) Acute Kidney Disease, (ii) Glomerular Disorders, (iii) Nephrolithiasis, and (iv) Tubular Disorders. Reports from each of these clusters were filtered using the most appropriate MedDRA terms. With this approach, it was possible not only to structure and clarify the most frequent renal phenotypes or those associated with a worse prognosis but also to recognize the most involved medications, those showing a greater association with different phenotypes, and to identify a set of molecules considered potential new nephrotoxins. From this work, besides the aforementioned findings, emerges the need for a greater number of studies in this area and the urgency to educate the various agents involved in the identification and reporting of adverse drug reactions. Enhancing competencies in this way will improve patient safety by enhancing medication safety.
Medications have transformed the world and have enabled an increase in average life expectancy, as well as its quality. However, like double-edged swords, they are significant contributors to morbidity and mortality within the context of adverse drug reactions. The kidneys, as detoxifying organs and key players in xenometabolism, are exceedingly exposed to all interactions with medications. Therefore, the development of adverse drug reactions with renal manifestations is more than expected. Despite the abundance of studies on the interaction between drugs and the kidneys, there is not only a noticeable dispersion and disorganization of existing information, but also significant gaps identified in the available data. Thus, this work aims not only to consolidate and add new data but also to identify emerging patterns and potential risks associated with new molecules, providing a solid foundation for future clinical interventions and health policies. The authors conducted a study based on VigiBase, structured into four main clusters of renal manifestations: (i) Acute Kidney Disease, (ii) Glomerular Disorders, (iii) Nephrolithiasis, and (iv) Tubular Disorders. Reports from each of these clusters were filtered using the most appropriate MedDRA terms. With this approach, it was possible not only to structure and clarify the most frequent renal phenotypes or those associated with a worse prognosis but also to recognize the most involved medications, those showing a greater association with different phenotypes, and to identify a set of molecules considered potential new nephrotoxins. From this work, besides the aforementioned findings, emerges the need for a greater number of studies in this area and the urgency to educate the various agents involved in the identification and reporting of adverse drug reactions. Enhancing competencies in this way will improve patient safety by enhancing medication safety.
Description
Keywords
Farmacovigilância Reações adversas medicamentosas Lesão renal aguda Desordens glomerulares