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Acetaminophen administration and the risk of acute kidney injury: a self-controlled case series study
BACKGROUND: Acetaminophen (APAP) is frequently used for analgesia and is considered safer than nonsteroidal anti-inflammatory drugs (NSAIDs) for the kidneys. However, there is little epidemiological evidence of the association between APAP and acute kidney injury (AKI). OBJECTIVES: To examine the as...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Dove Medical Press
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5846761/ https://www.ncbi.nlm.nih.gov/pubmed/29563839 http://dx.doi.org/10.2147/CLEP.S158110 |
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author | Hiragi, Shusuke Yamada, Hiroyuki Tsukamoto, Tatsuo Yoshida, Kazuki Kondo, Naoya Matsubara, Takeshi Yanagita, Motoko Tamura, Hiroshi Kuroda, Tomohiro |
author_facet | Hiragi, Shusuke Yamada, Hiroyuki Tsukamoto, Tatsuo Yoshida, Kazuki Kondo, Naoya Matsubara, Takeshi Yanagita, Motoko Tamura, Hiroshi Kuroda, Tomohiro |
author_sort | Hiragi, Shusuke |
collection | PubMed |
description | BACKGROUND: Acetaminophen (APAP) is frequently used for analgesia and is considered safer than nonsteroidal anti-inflammatory drugs (NSAIDs) for the kidneys. However, there is little epidemiological evidence of the association between APAP and acute kidney injury (AKI). OBJECTIVES: To examine the association between APAP and AKI using the self-controlled case series (SCCS) method, which is a novel strategy to control between-person confounders by comparing the risk and reference periods in each patient. METHODS: We performed SCCS in 1,871 patients (39.9% female) who were administered APAP and subsequently developed AKI, by reviewing electronically stored hospital information system data from May 2011 to July 2016. We used conditional Poisson regression to compare each patient’s risk and reference period. As a time-varying confounder, we adjusted the status of liver and kidney functions, systemic inflammation, and exposure to NSAIDs. RESULTS: We identified 5,650 AKI events during the 260,549 person-day observation period. The unadjusted incidences during the reference and exposure periods were 2.01/100 and 3.12/100 person-days, respectively. The incidence rate ratio adjusted with SCCS was 1.03 (95% confidence interval [CI]: 0.95–1.12). When we restricted endpoints as stage 2 AKI- and stage 3 AKI-level creatinine elevations, the incidence rate ratios were 1.20 (95% CI 0.91–1.58) and 1.20 (95% CI 0.62–2.31), respectively, neither of which was statistically significant. CONCLUSION: Our findings added epidemiological information for the relationship between APAP administration and AKI development. The results indicated scarce association between APAP and AKI, presumably supporting the general physicians’ impression that APAP is safer for kidney. |
format | Online Article Text |
id | pubmed-5846761 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Dove Medical Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-58467612018-03-21 Acetaminophen administration and the risk of acute kidney injury: a self-controlled case series study Hiragi, Shusuke Yamada, Hiroyuki Tsukamoto, Tatsuo Yoshida, Kazuki Kondo, Naoya Matsubara, Takeshi Yanagita, Motoko Tamura, Hiroshi Kuroda, Tomohiro Clin Epidemiol Original Research BACKGROUND: Acetaminophen (APAP) is frequently used for analgesia and is considered safer than nonsteroidal anti-inflammatory drugs (NSAIDs) for the kidneys. However, there is little epidemiological evidence of the association between APAP and acute kidney injury (AKI). OBJECTIVES: To examine the association between APAP and AKI using the self-controlled case series (SCCS) method, which is a novel strategy to control between-person confounders by comparing the risk and reference periods in each patient. METHODS: We performed SCCS in 1,871 patients (39.9% female) who were administered APAP and subsequently developed AKI, by reviewing electronically stored hospital information system data from May 2011 to July 2016. We used conditional Poisson regression to compare each patient’s risk and reference period. As a time-varying confounder, we adjusted the status of liver and kidney functions, systemic inflammation, and exposure to NSAIDs. RESULTS: We identified 5,650 AKI events during the 260,549 person-day observation period. The unadjusted incidences during the reference and exposure periods were 2.01/100 and 3.12/100 person-days, respectively. The incidence rate ratio adjusted with SCCS was 1.03 (95% confidence interval [CI]: 0.95–1.12). When we restricted endpoints as stage 2 AKI- and stage 3 AKI-level creatinine elevations, the incidence rate ratios were 1.20 (95% CI 0.91–1.58) and 1.20 (95% CI 0.62–2.31), respectively, neither of which was statistically significant. CONCLUSION: Our findings added epidemiological information for the relationship between APAP administration and AKI development. The results indicated scarce association between APAP and AKI, presumably supporting the general physicians’ impression that APAP is safer for kidney. Dove Medical Press 2018-03-06 /pmc/articles/PMC5846761/ /pubmed/29563839 http://dx.doi.org/10.2147/CLEP.S158110 Text en © 2018 Hiragi et al. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. |
spellingShingle | Original Research Hiragi, Shusuke Yamada, Hiroyuki Tsukamoto, Tatsuo Yoshida, Kazuki Kondo, Naoya Matsubara, Takeshi Yanagita, Motoko Tamura, Hiroshi Kuroda, Tomohiro Acetaminophen administration and the risk of acute kidney injury: a self-controlled case series study |
title | Acetaminophen administration and the risk of acute kidney injury: a self-controlled case series study |
title_full | Acetaminophen administration and the risk of acute kidney injury: a self-controlled case series study |
title_fullStr | Acetaminophen administration and the risk of acute kidney injury: a self-controlled case series study |
title_full_unstemmed | Acetaminophen administration and the risk of acute kidney injury: a self-controlled case series study |
title_short | Acetaminophen administration and the risk of acute kidney injury: a self-controlled case series study |
title_sort | acetaminophen administration and the risk of acute kidney injury: a self-controlled case series study |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5846761/ https://www.ncbi.nlm.nih.gov/pubmed/29563839 http://dx.doi.org/10.2147/CLEP.S158110 |
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