Acute Kidney Injury

Acute Kidney Injury Caused by Medication Errors: What You Need to Know

Acute Kidney Injury and Renal Failure

Acute kidney injury (AKI) is a sudden decline in kidney function that can develop over hours or days. It is typically marked by reduced urine output and rising levels of waste products in the blood, such as creatinine or urea. In severe cases, AKI can progress to renal failure, requiring emergency dialysis or resulting in long-term kidney damage. When left unrecognized or untreated, AKI may lead to serious complications, including permanent disability or death.

Causes of Acute Kidney Injury and Renal Failure

AKI may be triggered by conditions that impair blood flow to the kidneys (e.g., dehydration, heart failure), obstruct urinary output, or damage the kidney tissue directly. However, one of the most frequent and preventable causes in hospitalized patients is medication-related injury. Certain drugs are toxic to the kidneys, particularly when improperly prescribed, administered in the wrong dose, or given without regard for the patient’s renal function. These medication errors can turn an otherwise reversible condition into a catastrophic outcome.

Common causes of medication-related AKI include:

• Overuse of nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen, especially in elderly or dehydrated patients
• Incorrect dosing of nephrotoxic antibiotics, including aminoglycosides or vancomycin
• Failure to adjust doses of medications based on impaired kidney function
• Harmful drug combinations, such as ACE inhibitors and diuretics given together without proper monitoring
• Lack of preventive measures before administering IV contrast, which is known to cause contrast-induced nephropathy in vulnerable patients

IS Acute Kidney Injury Always Caused by Malpractice?

No, not all cases of AKI are the result of malpractice. However, malpractice may be present when medical professionals fail to follow well-established protocols for medication safety and kidney protection. This includes:

• Not reviewing a patient’s current kidney function before prescribing potentially harmful drugs
• Failing to monitor labs such as creatinine, BUN, or urine output when high-risk medications are given
• Overlooking medication interactions known to increase the risk of renal damage
• Ignoring early signs of kidney injury and failing to adjust or stop medications accordingly

When such failures lead to preventable kidney damage, the provider may be legally responsible for the harm caused.

How Medication Errors Cause Preventable Harm

Medication errors are a leading contributor to preventable AKI and renal failure in hospitalized patients. Examples include:

• Prescribing or continuing nephrotoxic medications despite abnormal kidney function: A patient with a high creatinine level is prescribed NSAIDs or contrast agents without dose adjustment or protective measures.
• Administering excessive doses: Renally cleared medications like certain antivirals, chemotherapy drugs, or antibiotics can accumulate and damage kidney tissue when not properly dosed.
• Failure to monitor lab results: Providers who ignore rising creatinine or missed urine output fail to act on early signs of injury.
• Contrast-induced nephropathy: When patients with pre-existing kidney disease receive iodinated contrast during imaging procedures without IV hydration or alternatives, AKI is a known and avoidable risk.
• Polypharmacy without oversight: The simultaneous use of several nephrotoxic drugs without coordination or renal consultation increases the risk of injury.

Each of these examples reflects preventable harm that may form the basis of a medical malpractice claim.

When Can a Lawsuit Be Filed?

A lawsuit may be appropriate when AKI or renal failure occurs due to medication errors and leads to serious, lasting harm. The legal claim must establish:

1. A duty of care, such as through a physician-patient relationship
2. A breach of the standard of care, such as improper prescribing or lack of monitoring
3. Causation, showing the error directly led to AKI or renal failure
4. Damages, such as the need for dialysis, long-term kidney disease, or death

Malpractice claims require expert medical testimony to confirm that the injury was preventable and directly caused by negligent medical care.

Real Case Examples: Verdicts & Settlements

• $24.7 Million Verdict – Hospital AKI Case
  A jury awarded $24.7 million—the largest hospital AKI award in the state—after a patient suffered severe kidney damage due to provider negligence.
• $10.5 Million Settlement – Failure to Monitor NSAIDs
  A veteran’s kidney function dropped drastically after being prescribed naproxen despite earlier lab results indicating severe CKD. The VA admitted its failure to follow up and he was given NSAIDs, resulting in end-stage renal failure. The case settled for $10.5 million.
• $10 Million Verdict – Nephrologist Liability
  A jury in another case held a nephrologist responsible for AKI after failing to promptly address rising creatinine. A verdict of $10 million was awarded against the provider.

Why These Cases Matter

Each of these cases demonstrates how routine medication management can become deadly when standard precautions are ignored. Courts consistently affirm that preventable renal failure—especially when tied to poor medication practices—represents a serious breach of trust and medical duty. The long-term impacts on quality of life, healthcare costs, and survival can be profound.

What You Should Do If You Suspect Malpractice

If you or a loved one experienced AKI or renal failure during hospitalization, and you believe a medication error may be responsible:

• Request all medical records, including lab results, medication administration logs, and physician orders
• Preserve discharge summaries and notes from nephrology, pharmacy, or critical care teams
• Contact a qualified medical malpractice attorney for case review
• Do not delay: Evidence may be lost and legal deadlines may apply

We Can Help

At Lupetin & Unatin, we are dedicated to helping patients and families whose lives have been affected by severe medical errors. If AKI or renal failure resulted from mismanaged medications, contrast procedures, or neglect, we can investigate, bring in medical experts, and pursue justice. Contact us today for a free, confidential consultation.