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Loop Diuretics Are Associated with Increased Risk of Hospital-Acquired Acute Kidney Injury in Adult Patients: A Retrospective Study

Background: The association between loop diuretics and acute kidney injury (AKI) remains unclear. Methods: The population studied was selected from the Epidemiology of AKI in Chinese Hospitalized patients (EACH) study. Exposure to loop diuretics was defined as any filled prescription prior to the da...

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Autores principales: Zhou, Liping, Li, Yanqin, Gao, Qi, Lin, Yuxin, Su, Licong, Chen, Ruixuan, Cao, Yue, Xu, Ruqi, Luo, Fan, Gao, Peiyan, Zhang, Xiaodong, Li, Pingping, Nie, Sheng, Tang, Ying, Xu, Xin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9267783/
https://www.ncbi.nlm.nih.gov/pubmed/35806949
http://dx.doi.org/10.3390/jcm11133665
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author Zhou, Liping
Li, Yanqin
Gao, Qi
Lin, Yuxin
Su, Licong
Chen, Ruixuan
Cao, Yue
Xu, Ruqi
Luo, Fan
Gao, Peiyan
Zhang, Xiaodong
Li, Pingping
Nie, Sheng
Tang, Ying
Xu, Xin
author_facet Zhou, Liping
Li, Yanqin
Gao, Qi
Lin, Yuxin
Su, Licong
Chen, Ruixuan
Cao, Yue
Xu, Ruqi
Luo, Fan
Gao, Peiyan
Zhang, Xiaodong
Li, Pingping
Nie, Sheng
Tang, Ying
Xu, Xin
author_sort Zhou, Liping
collection PubMed
description Background: The association between loop diuretics and acute kidney injury (AKI) remains unclear. Methods: The population studied was selected from the Epidemiology of AKI in Chinese Hospitalized patients (EACH) study. Exposure to loop diuretics was defined as any filled prescription prior to the date when AKI was detected in patients with HA-AKI, and prior to the last date of SCr testing in those without AKI. The outcome was AKI, defined by the Kidney Disease Improving Global Outcomes criteria. Associations between loop diuretics and HA-AKI were examined by Cox proportional hazards models adjusted for baseline and time-dependent covariates. Results: Of the 150,020 patients, 16,437 (11.0%) were prescribed loop diuretics, and 5717 (3.8%) experienced HA-AKI events. The crude rates of HA-AKI in patients who were and were not prescribed loop diuretics were 1632 (9.9%) and 3262 (2.8%), respectively. A multivariate cox proportional hazards analysis showed that exposure to loop diuretics was associated with significantly increased risks of HA-AKI compared with non-users (hazard ratio (HR), 1.61; 95% CI (confidence interval), 1.55–1.67), other diuretics (HR, 1.09; 95% CI, 1.03–1.15), and osmotic diuretics (HR, 1.30; 95% CI, 1.20–1.42). Compared with other diuretics, the use of loop diuretics was associated with higher risks of HA-AKI in women, in patients without hypertension, in patients without heart failure, in patients without liver cirrhosis, and in patients not requiring surgery. Conclusions: Loop diuretics are widely used and are associated with increased risks of HA-AKI in hospitalized adults. Renal function should be more closely monitored during the use of loop diuretics.
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spelling pubmed-92677832022-07-09 Loop Diuretics Are Associated with Increased Risk of Hospital-Acquired Acute Kidney Injury in Adult Patients: A Retrospective Study Zhou, Liping Li, Yanqin Gao, Qi Lin, Yuxin Su, Licong Chen, Ruixuan Cao, Yue Xu, Ruqi Luo, Fan Gao, Peiyan Zhang, Xiaodong Li, Pingping Nie, Sheng Tang, Ying Xu, Xin J Clin Med Article Background: The association between loop diuretics and acute kidney injury (AKI) remains unclear. Methods: The population studied was selected from the Epidemiology of AKI in Chinese Hospitalized patients (EACH) study. Exposure to loop diuretics was defined as any filled prescription prior to the date when AKI was detected in patients with HA-AKI, and prior to the last date of SCr testing in those without AKI. The outcome was AKI, defined by the Kidney Disease Improving Global Outcomes criteria. Associations between loop diuretics and HA-AKI were examined by Cox proportional hazards models adjusted for baseline and time-dependent covariates. Results: Of the 150,020 patients, 16,437 (11.0%) were prescribed loop diuretics, and 5717 (3.8%) experienced HA-AKI events. The crude rates of HA-AKI in patients who were and were not prescribed loop diuretics were 1632 (9.9%) and 3262 (2.8%), respectively. A multivariate cox proportional hazards analysis showed that exposure to loop diuretics was associated with significantly increased risks of HA-AKI compared with non-users (hazard ratio (HR), 1.61; 95% CI (confidence interval), 1.55–1.67), other diuretics (HR, 1.09; 95% CI, 1.03–1.15), and osmotic diuretics (HR, 1.30; 95% CI, 1.20–1.42). Compared with other diuretics, the use of loop diuretics was associated with higher risks of HA-AKI in women, in patients without hypertension, in patients without heart failure, in patients without liver cirrhosis, and in patients not requiring surgery. Conclusions: Loop diuretics are widely used and are associated with increased risks of HA-AKI in hospitalized adults. Renal function should be more closely monitored during the use of loop diuretics. MDPI 2022-06-24 /pmc/articles/PMC9267783/ /pubmed/35806949 http://dx.doi.org/10.3390/jcm11133665 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Zhou, Liping
Li, Yanqin
Gao, Qi
Lin, Yuxin
Su, Licong
Chen, Ruixuan
Cao, Yue
Xu, Ruqi
Luo, Fan
Gao, Peiyan
Zhang, Xiaodong
Li, Pingping
Nie, Sheng
Tang, Ying
Xu, Xin
Loop Diuretics Are Associated with Increased Risk of Hospital-Acquired Acute Kidney Injury in Adult Patients: A Retrospective Study
title Loop Diuretics Are Associated with Increased Risk of Hospital-Acquired Acute Kidney Injury in Adult Patients: A Retrospective Study
title_full Loop Diuretics Are Associated with Increased Risk of Hospital-Acquired Acute Kidney Injury in Adult Patients: A Retrospective Study
title_fullStr Loop Diuretics Are Associated with Increased Risk of Hospital-Acquired Acute Kidney Injury in Adult Patients: A Retrospective Study
title_full_unstemmed Loop Diuretics Are Associated with Increased Risk of Hospital-Acquired Acute Kidney Injury in Adult Patients: A Retrospective Study
title_short Loop Diuretics Are Associated with Increased Risk of Hospital-Acquired Acute Kidney Injury in Adult Patients: A Retrospective Study
title_sort loop diuretics are associated with increased risk of hospital-acquired acute kidney injury in adult patients: a retrospective study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9267783/
https://www.ncbi.nlm.nih.gov/pubmed/35806949
http://dx.doi.org/10.3390/jcm11133665
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