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Medication use, renin–angiotensin system inhibitors, and acute care utilization after hospitalization in patients with chronic kidney disease

OBJECTIVES: The aims of this secondary analysis were to: (a) characterize medication use following hospital discharge for patients with chronic kidney disease (CKD), and (b) investigate relationships of medication use with the primary composite outcome of acute care utilization 90 days after hospita...

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Autores principales: Neumiller, Joshua J, Daratha, Kenn B, Alicic, Radica Z, Short, Robert A, Miller, Haleigh M, Gregg, Liza, Gates, Brian J, Corbett, Cynthia F, McPherson, Sterling M, Tuttle, Katherine R
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7418245/
https://www.ncbi.nlm.nih.gov/pubmed/32762427
http://dx.doi.org/10.1177/1470320320945137
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author Neumiller, Joshua J
Daratha, Kenn B
Alicic, Radica Z
Short, Robert A
Miller, Haleigh M
Gregg, Liza
Gates, Brian J
Corbett, Cynthia F
McPherson, Sterling M
Tuttle, Katherine R
author_facet Neumiller, Joshua J
Daratha, Kenn B
Alicic, Radica Z
Short, Robert A
Miller, Haleigh M
Gregg, Liza
Gates, Brian J
Corbett, Cynthia F
McPherson, Sterling M
Tuttle, Katherine R
author_sort Neumiller, Joshua J
collection PubMed
description OBJECTIVES: The aims of this secondary analysis were to: (a) characterize medication use following hospital discharge for patients with chronic kidney disease (CKD), and (b) investigate relationships of medication use with the primary composite outcome of acute care utilization 90 days after hospitalization. METHODS: The CKD-Medication Intervention Trial (CKD-MIT) enrolled acutely ill hospitalized patients with CKD stages 3–5 not dialyzed (CKD 3–5 ND). In this post hoc analysis, data for medication use were characterized, and the relationship of medication use with the primary outcome was evaluated using Cox proportional hazards models. RESULTS: Participants were taking a mean of 12.6 (standard deviation=5.1) medications, including medications from a wide variety of medication classes. Nearly half of study participants were taking angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARB). ACE inhibitor/ARB use was associated with decreased risk of the primary outcome (hazard ratio=0.51; 95% confidence interval 0.28–0.95; p=0.03) after adjustment for baseline estimated glomerular filtration rate, age, sex, race, blood pressure, albuminuria, and potential nephrotoxin use. CONCLUSIONS: A large number, variety, and complexity of medications were used by hospitalized patients with CKD 3–5 ND. ACE inhibitor or ARB use at hospital discharge was associated with a decreased risk of 90-day acute care utilization.
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spelling pubmed-74182452020-08-24 Medication use, renin–angiotensin system inhibitors, and acute care utilization after hospitalization in patients with chronic kidney disease Neumiller, Joshua J Daratha, Kenn B Alicic, Radica Z Short, Robert A Miller, Haleigh M Gregg, Liza Gates, Brian J Corbett, Cynthia F McPherson, Sterling M Tuttle, Katherine R J Renin Angiotensin Aldosterone Syst Original Article OBJECTIVES: The aims of this secondary analysis were to: (a) characterize medication use following hospital discharge for patients with chronic kidney disease (CKD), and (b) investigate relationships of medication use with the primary composite outcome of acute care utilization 90 days after hospitalization. METHODS: The CKD-Medication Intervention Trial (CKD-MIT) enrolled acutely ill hospitalized patients with CKD stages 3–5 not dialyzed (CKD 3–5 ND). In this post hoc analysis, data for medication use were characterized, and the relationship of medication use with the primary outcome was evaluated using Cox proportional hazards models. RESULTS: Participants were taking a mean of 12.6 (standard deviation=5.1) medications, including medications from a wide variety of medication classes. Nearly half of study participants were taking angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARB). ACE inhibitor/ARB use was associated with decreased risk of the primary outcome (hazard ratio=0.51; 95% confidence interval 0.28–0.95; p=0.03) after adjustment for baseline estimated glomerular filtration rate, age, sex, race, blood pressure, albuminuria, and potential nephrotoxin use. CONCLUSIONS: A large number, variety, and complexity of medications were used by hospitalized patients with CKD 3–5 ND. ACE inhibitor or ARB use at hospital discharge was associated with a decreased risk of 90-day acute care utilization. SAGE Publications 2020-08-07 /pmc/articles/PMC7418245/ /pubmed/32762427 http://dx.doi.org/10.1177/1470320320945137 Text en © The Author(s) 2020 https://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Article
Neumiller, Joshua J
Daratha, Kenn B
Alicic, Radica Z
Short, Robert A
Miller, Haleigh M
Gregg, Liza
Gates, Brian J
Corbett, Cynthia F
McPherson, Sterling M
Tuttle, Katherine R
Medication use, renin–angiotensin system inhibitors, and acute care utilization after hospitalization in patients with chronic kidney disease
title Medication use, renin–angiotensin system inhibitors, and acute care utilization after hospitalization in patients with chronic kidney disease
title_full Medication use, renin–angiotensin system inhibitors, and acute care utilization after hospitalization in patients with chronic kidney disease
title_fullStr Medication use, renin–angiotensin system inhibitors, and acute care utilization after hospitalization in patients with chronic kidney disease
title_full_unstemmed Medication use, renin–angiotensin system inhibitors, and acute care utilization after hospitalization in patients with chronic kidney disease
title_short Medication use, renin–angiotensin system inhibitors, and acute care utilization after hospitalization in patients with chronic kidney disease
title_sort medication use, renin–angiotensin system inhibitors, and acute care utilization after hospitalization in patients with chronic kidney disease
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7418245/
https://www.ncbi.nlm.nih.gov/pubmed/32762427
http://dx.doi.org/10.1177/1470320320945137
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