| アブストラクト | 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. |
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| ジャーナル名 | BMC nephrology |
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| Pubmed追加日 | 2020/1/1 |
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| 投稿者 | Scott, Jemima; Jones, Tim; Redaniel, Maria Theresa; May, Margaret T; Ben-Shlomo, Yoav; Caskey, Fergus |
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| 組織名 | Richard Bright Renal Unit, Southmead Hospital, Bristol, BS10 5NB, UK.;jemimascott@doctors.org.uk.;Bristol Medical School: Population Health Sciences, University of Bristol,;Bristol, UK. jemimascott@doctors.org.uk.;Bristol, UK.;NIHR CLAHRC West, University of Bristol, Bristol, UK.;UK Renal Registry, Bristol, UK. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/31888533/ |
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