Metamizole-Associated Risks in Decompensated Hepatic Cirrhosis.
Dtsch Arztebl Int
; 119(41): 687-693, 2022 10 14.
Article
en En
| MEDLINE
| ID: mdl-35912424
ABSTRACT
BACKGROUND:
Because of the increased risk of acute renal failure (ARF), the use of cyclooxygenase (COX) inhibitors is not recommended in patients with decompensated hepatic cirrhosis. Metamizole is not a classic COX inhibitor, but there are insufficient data to support its safe use. In this study, we investigate the effect of metamizole on the risk of ARF in these patients.METHODS:
Metamizole use, ARF incidence, and patient mortality were examined in a large, retrospective, exploratory cohort and validated with data from a prospective registry.RESULTS:
523 patients were evaluated in the exploratory cohort. Metamizole use at baseline was documented in 110 cases (21%) and was independently associated with the development of ARF, severe (grade 3) ARF, and lower survival without liver transplantation at follow-up on day 28 (HR 2.2, p < 0.001; HR 2.8, p < 0.001; and HR 2.6, p < 0.001, respectively). Interestingly, the risk of ARF depended on the dose of metamizole administered (HR 1.038, p < 0.001). Compared to patients who were treated with opioids, the rate of ARF was higher in the metamizole group (49% vs. 79%, p = 0.014). An increased risk of ARF with metamizole use was also demonstrated in the independent validation cohort (p < 0.001).CONCLUSION:
Metamizole therapy, especially at high doses, should only be used with a high level of caution in patients with decompensated cirrhosis.
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Dipirona
/
Lesión Renal Aguda
Tipo de estudio:
Etiology_studies
/
Risk_factors_studies
Límite:
Humans
Idioma:
En
Año:
2022
Tipo del documento:
Article