Search: onr:"swepub:oai:prod.swepub.kib.ki.se:145343323" >
Initiation of sodiu...
Initiation of sodium polystyrene sulphonate and the risk of gastrointestinal adverse events in advanced chronic kidney disease: a nationwide study
-
Laureati, P (author)
-
- Xu, Y (author)
- Karolinska Institutet
-
- Trevisan, M (author)
- Karolinska Institutet
-
show more...
-
Schalin, L (author)
-
Mariani, I (author)
-
- Bellocco, R (author)
- Karolinska Institutet
-
Sood, MM (author)
-
- Barany, P (author)
- Karolinska Institutet
-
- Sjolander, A (author)
- Karolinska Institutet
-
- Evans, M (author)
- Karolinska Institutet
-
- Carrero, JJ (author)
- Karolinska Institutet
-
show less...
-
(creator_code:org_t)
- 2019-08-04
- 2020
- English.
-
In: 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
- Related links:
-
https://doi.org/10.1...
-
show more...
-
http://kipublication...
-
https://doi.org/10.1...
-
show less...
Abstract
Subject headings
Close
- 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.
Publication and Content Type
- ref (subject category)
- art (subject category)
Find in a library
To the university's database
- By the author/editor
-
Laureati, P
-
Xu, Y
-
Trevisan, M
-
Schalin, L
-
Mariani, I
-
Bellocco, R
-
show more...
-
Sood, MM
-
Barany, P
-
Sjolander, A
-
Evans, M
-
Carrero, JJ
-
show less...
- Articles in the publication
-
Nephrology, dial ...
-
Nephrology Dialy ...
- By the university
-
Karolinska Institutet