Estimating the risk of acute kidney injury associated with use of diuretics and renin angiotensin aldosterone system inhibitors: A population based cohort study using the clinical practice research datalink.
BMC Nephrol
; 20(1): 481, 2019 12 30.
Article
em En
| MEDLINE
| ID: mdl-31888533
ABSTRACT
BACKGROUND:
The risk of acute kidney injury (AKI) attributable to renin angiotensin aldosterone (RAAS) inhibitors and diuretics remains unclear.METHODS:
We conducted a prospective cohort study using the Clinical Practice Research Datalink (2008-2015) linked to Hospital Episode Statistics - Admitted Patient Care and Office for National Statistics mortality data. Patients were included if they had one or more chronic diagnoses requiring medication. Exposed patients had a first ever prescription for RAAS inhibitors/diuretics during the study period. AKI risk associated with exposure was determined by multivariable Cox regression, propensity score-adjusted Cox regression and a prior event rate ratio (PERR) analysis.RESULTS:
One hundred forty thousand nine hundred fifty-two individuals were included. Increased AKI risk in the exposed group was demonstrated in both the multivariable and propensity score-adjusted cox regressions (HR 1.23 (95% CI 1.04-1.45) and HR 1.24 (1.05-1.47) respectively). The PERR analysis provided a similar overall hazard ratio with a wider confidence interval (HR 1.29 (0.94-1.63)). The increased AKI risk in the exposed group was present only in those receiving two or more antihypertensives. Absolute AKI risk was small.CONCLUSIONS:
RAAS inhibitors/diuretics result in an increased risk of AKI. The absolute increase in AKI risk is small, however, and needs to be considered in the context of any potential benefits.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Sistema Renina-Angiotensina
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Inibidores da Enzima Conversora de Angiotensina
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Diuréticos
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Antagonistas de Receptores de Mineralocorticoides
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Injúria Renal Aguda
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Antagonistas de Receptores de Angiotensina
Tipo de estudo:
Diagnostic_studies
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Etiology_studies
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Incidence_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
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Screening_studies
Limite:
Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article