دورية أكاديمية
Non-steroidal anti-inflammatory drugs, renin-angiotensin system blockade or diuretics and risk of acute kidney injury: A case-crossover study.
| العنوان: | Non-steroidal anti-inflammatory drugs, renin-angiotensin system blockade or diuretics and risk of acute kidney injury: A case-crossover study. |
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| المؤلفون: | Weng SE; Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Pharmacy, Taipei City Hospital, Zhongxing Branch, Taipei, Taiwan., Hsu WT; Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan; School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan., Hsiao FY; Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan; School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan. Electronic address: fyshsiao@ntu.edu.tw., Lee CM; Department of Cardiology, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City, Taiwan. Electronic address: chiiminglee@gmail.com. |
| المصدر: | Archives of gerontology and geriatrics [Arch Gerontol Geriatr] 2024 Aug; Vol. 123, pp. 105394. Date of Electronic Publication: 2024 Mar 26. |
| نوع المنشور: | Journal Article; Research Support, Non-U.S. Gov't |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Biomedical Press Country of Publication: Netherlands NLM ID: 8214379 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1872-6976 (Electronic) Linking ISSN: 01674943 NLM ISO Abbreviation: Arch Gerontol Geriatr Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Amsterdam : Elsevier Biomedical Press, c1982- |
| مواضيع طبية MeSH: | Acute Kidney Injury*/chemically induced , Acute Kidney Injury*/epidemiology , Anti-Inflammatory Agents, Non-Steroidal*/adverse effects , Cross-Over Studies* , Diuretics*/adverse effects , Diuretics*/therapeutic use, Humans ; Male ; Female ; Aged ; Middle Aged ; Renin-Angiotensin System/drug effects ; Taiwan/epidemiology ; Risk Factors ; Drug Therapy, Combination/adverse effects ; Angiotensin-Converting Enzyme Inhibitors/adverse effects ; Case-Control Studies ; Aged, 80 and over |
| مستخلص: | Background: Aging-related physiological changes, such as decline in renal function, not only exacerbates pre-existing comorbidities but also escalate the susceptibility to adverse events. Previous studies have shown that non-steroidal anti-inflammatory drugs (NSAIDs) are associated with an increased risk of acute kidney injury (AKI), and the concomitant use of renin-angiotensin system blockade or diuretics may further potentiate the risk. However, studies evaluating the risk of AKI associated with NSAIDs (including routes, concomitant use of different NSAIDs, categories (traditional NSAIDs or COX-2 inhibitors), and cumulative doses of NSAIDs) are limited, particularly the risk of AKI associated with the dual or triple combination of NSAIDs with renin-angiotensin system blockade (RAS blockades) and/or diuretics. Methods: A case-crossover study utilized two sets of longitudinal data from Taiwan's National Health Insurance Research Database (NHIRD). Newly admitted patients with a primary AKI diagnosis were included, with the index date defined as the first admission date. The 1-7 days and 181-187 days prior to the index date served as the case and control periods. Exposure to NSAIDs and co-exposures of RAS blockade and/or diuretics were assessed in both periods. Multivariable conditional logistic regression models, adjusting for potential confounders, estimated adjusted odds ratios (aORs) and 95 % confidence intervals (CIs) for AKI associated with NSAIDs, dual, or triple combinations. Sensitivity analyses explored result robustness by varying case and control period lengths. Results: The study included 1,284 newly diagnosed AKI patients. NSAIDs showed a 3.55-fold increased risk of AKI (aOR: 3.55; 95 % CI 2.70-4.65), with similar risks for traditional NSAIDs and COX-2 inhibitors. Use of multiple NSAIDs, parenteral dosage forms, and higher cumulative doses increased AKI risk. Dual combination with either RAS blockade or diuretics resulted in a 2.90-fold (aOR: 2.90; 95 %CI 1.47-5.70) and 12.68-fold (aOR: 12.68; 95 %CI 6.15-26.12) risk, respectively. The highest risk occurred with triple combination (aOR: 29.22; 95 %CI 12.82-66.64). Conclusions: NSAIDs, including both non-selective NSAIDs and COX2 inhibitors, elevate the risk of AKI. Increased AKI risk is linked to using multiple NSAIDs, the parenteral dosage form, and higher cumulative doses. Dual combination of RAS blockade with NSAIDs or diuretics with NSAIDs, as well as triple therapy, heightens the risk, with the latter associated with the highest risk of AKI. Competing Interests: Declaration of competing interest The authors declare no conflicts of interest. (Copyright © 2024. Published by Elsevier B.V.) |
| فهرسة مساهمة: | Keywords: Acute kidney injury; Case-crossover study; Diuretics, Drug-drug interactions; Nonsteroidal anti-inflammatory drugs (NSAIDS); Renin-angiotensin system blockade (Ras blockade) |
| المشرفين على المادة: | 0 (Anti-Inflammatory Agents, Non-Steroidal) 0 (Diuretics) 0 (Angiotensin-Converting Enzyme Inhibitors) |
| تواريخ الأحداث: | Date Created: 20240327 Date Completed: 20240604 Latest Revision: 20240924 |
| رمز التحديث: | 20240924 |
| DOI: | 10.1016/j.archger.2024.105394 |
| PMID: | 38537386 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1872-6976 |
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| DOI: | 10.1016/j.archger.2024.105394 |