Calcineurin-inhibitor nephrotoxicity incidence

Method

Proportion of ciclosporin- or tacrolimus-treated patients with clinician-adjudicated calcineurin-inhibitor nephrotoxicity - a sustained renal function decline attributed to the drug, with or without histological confirmation of arteriolar hyalinosis or striped interstitial fibrosis - pooled as a risk ratio.

The method is part of the endpoint identity. Studies measuring the same quantity by a different method are held as separate endpoints.

Notes

Chronic, cumulative, exposure-dependent, and assigned by clinical attribution. The near-miss is contrast-associated acute kidney injury (PMID 38189088): both are drug-induced renal injury events, but that one is defined mechanically by a creatinine rise within 48 to 72 hours of a single exposure while this is an attribution made over months of continuous dosing. Distinct also from CAT:outcome/serum-creatinine and CAT:outcome/egfr, the continuous measurements that underlie but do not equal the adjudicated event, and from acute graft rejection, which is immune-mediated.