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Initiation of sodiu...
Initiation of sodium polystyrene sulphonate and the risk of gastrointestinal adverse events in advanced chronic kidney disease: a nationwide study
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Laureati, P (författare)
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- Xu, Y (författare)
- Karolinska Institutet
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- Trevisan, M (författare)
- Karolinska Institutet
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Schalin, L (författare)
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Mariani, I (författare)
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- Bellocco, R (författare)
- Karolinska Institutet
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Sood, MM (författare)
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- Barany, P (författare)
- Karolinska Institutet
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- Sjolander, A (författare)
- Karolinska Institutet
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- Evans, M (författare)
- Karolinska Institutet
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- Carrero, JJ (författare)
- Karolinska Institutet
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(creator_code:org_t)
- 2019-08-04
- 2020
- Engelska.
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Ingår i: Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association. - : Oxford University Press (OUP). - 1460-2385. ; 35:9, s. 1518-1526
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https://doi.org/10.1...
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http://kipublication...
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https://doi.org/10.1...
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Abstract
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- BackgroundDespite long-standing clinical use of sodium polystyrene sulphonate (SPS) for hyperkalaemia management in chronic kidney disease (CKD), its safety profile remains poorly investigated.MethodsWe undertook an observational analysis of nephrology-referred adults with incident CKD Stage 4+ in Sweden during 2006–16 and with no previous SPS use. We studied patterns of use and adverse events associated to SPS initiation during follow-up. Patterns of SPS use were defined by chronicity of treatment and by prescribed dose. We estimated hazard ratios (HRs) and 95% confidence intervals (CIs) associated with SPS initiation (time-varying exposure) for the risk of severe (intestinal ischaemia, thrombosis or ulceration/perforation) and minor (de novo dispensation of laxatives or anti-diarrheal drugs) gastrointestinal (GI) events.ResultsOf 19 530 SPS-naïve patients with CKD, 3690 initiated SPS during follow-up. A total of 59% took SPS chronically, with an average of three dispensations/year. The majority (85%) were prescribed lower dosages than specified on the product label. During follow-up, 202 severe and 1149 minor GI events were recorded. SPS initiation was associated with a higher incidence of severe adverse events [adjusted HR 1.25 95% CI 1.05–1.49)], particularly in those receiving per label doses [1.54 (1.09–2.17)] and mainly attributed to ulcers and perforations. SPS initiation was also associated with higher incidence of minor GI events [adjusted HR 1.11 (95% CI 1.03–1.19)], regardless of dose, and mainly accounted for by de novo dispensation of laxatives.ConclusionsInitiation of SPS in patients with advanced CKD is associated with a higher risk of severe GI complications as well as the initiation of GI-related medications, particularly when prescribed at per label doses.
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Laureati, P
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Xu, Y
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Trevisan, M
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Schalin, L
-
Mariani, I
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Bellocco, R
-
visa fler...
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Sood, MM
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Barany, P
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Sjolander, A
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Evans, M
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Carrero, JJ
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visa färre...
- Artiklar i publikationen
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Nephrology, dial ...
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Nephrology Dialy ...
- Av lärosätet
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Karolinska Institutet