La prescription de médicaments néphrotoxiques chez les enfants atteints d'insuffisance rénale aiguë et chronique

 

Claire Lefebvre

Centre universitaire de santé McGill [CUSM]

 

Domaine : santé de la mère, des enfants et des adolescents

Programme : Formation de maîtrise

Concours 2017-2018

Partenaire:

Fondation des Étoiles

My project will help us understand how doctors currently prescribe certain medications to children with kidney damage.

There are two types of kidney damage in children. It can be chronic and long term or it can be acute (referred to as acute kidney injury) meaning there is a sudden decrease in the kidneys' functioning which may recover partially. We know that having acute kidney injury can increase the chances of developing long-term kidney damage even when the function of the damaged kidneys seems to recover. To limit kidney damage, it is very important to avoid prescribing medications that are potentially toxic to injured kidneys. These are referred to as "nephrotoxic" medications. Unfortunately, in adults, there are studies showing that many people with kidney damage are still being prescribed nephrotoxic medications.

Like adults, children with chronic kidney disease or past episodes of acute kidney injury should not be prescribed these medications unless absolutely necessary. Unfortunately, no one has done research to evaluate whether this is the currently the case in children. I therefore propose to do a study to evaluate whether doctors currently prescribe nephrotoxic medications to children with kidney damage. My suspicion is that these at-risk children are being prescribed nephrotoxic medications as much as children with healthy kidneys. To see whether my suspicions are correct, I am going to look at the medications that are prescribed to children who have had acute kidney injury and chronic kidney damage compared to children who have normal kidney function. Ideally, children with kidney damage will be prescribed fewer of these medications.

This research will be important. If I find that nephrotoxic medications are being prescribed to children with kidney disease, this will represent a huge opportunity to create programs to inform doctors, patients and pharmacists about this reality to help change it.