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  • Bosi, AlessandroKarolinska Inst, Dept Med Epidemiol & Biostat, Stockholm, Sweden. (författare)

Use of nephrotoxic medications in adults with chronic kidney disease in Swedish and US routine care

  • Artikel/kapitelEngelska2022

Förlag, utgivningsår, omfång ...

  • 2021-10-29
  • Oxford University Press (OUP),2022
  • electronicrdacarrier

Nummerbeteckningar

  • LIBRIS-ID:oai:DiVA.org:uu-479415
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-479415URI
  • https://doi.org/10.1093/ckj/sfab210DOI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:148994342URI

Kompletterande språkuppgifter

  • Språk:engelska
  • Sammanfattning på:engelska

Ingår i deldatabas

Klassifikation

  • Ämneskategori:ref swepub-contenttype
  • Ämneskategori:art swepub-publicationtype

Anmärkningar

  • Background: To characterize the use of nephrotoxic medications in patients with chronic kidney disease (CKD) Stages G3-5 in routine care.Methods: We studied cohorts of adults with confirmed CKD G3-5 undergoing routine care from 1 January 2016 through 31 December 2018 in two health systems [Stockholm CREAtinine Measurements (SCREAM), Stockholm, Sweden (N = 57 880) and Geisinger, PA, USA (N = 16 255)]. We evaluated the proportion of patients receiving nephrotoxic medications within 1 year overall and by baseline kidney function, ranked main contributors and examined the association between receipt of nephrotoxic medication and age, sex, CKD G-stages comorbidities and provider awareness of the patient's CKD using multivariable logistic regression.Results: During a 1-year period, 20% (SCREAM) and 17% (Geisinger) of patients with CKD received at least one nephrotoxic medication. Among the top nephrotoxic medications identified in both cohorts were non-steroidal anti-inflammatory drugs (given to 11% and 9% of patients in SCREAM and Geisinger, respectively), antivirals (2.5% and 2.0%) and immunosuppressants (2.7% and 1.5%). Bisphosphonate use was common in SCREAM (3.3%) and fenofibrates in Geisinger (3.6%). Patients <65 years of age, women and those with CKD G3 were at higher risk of receiving nephrotoxic medications in both cohorts. Notably, provider awareness of a patient's CKD was associated with lower odds of nephrotoxic medication use {odds ratios [OR] 0.85[95% confidence interval (CI) 0.80-0.90] in SCREAM and OR 0.80 [95% CI 0.72-0.89] in Geisinger}.Conclusions: One in five patients with CKD received nephrotoxic medications in two distinct health systems. Strategies to increase physician's awareness of patients' CKD and knowledge of drug nephrotoxicity may reduce prescribing nephrotoxic medications and prevent iatrogenic kidney injury.

Ämnesord och genrebeteckningar

Biuppslag (personer, institutioner, konferenser, titlar ...)

  • Xu, YunwenJohns Hopkins Bloomberg Sch Publ Hlth, Dept Epidemiol, Baltimore, MD 21205 USA. (författare)
  • Gasparini, AlessandroKarolinska Institutet (författare)
  • Wettermark, BjörnUppsala universitet,Institutionen för farmaci(Swepub:uu)bjowe336 (författare)
  • Barany, PeterKarolinska Institutet (författare)
  • Bellocco, RinoKarolinska Institutet (författare)
  • Inker, Lesley A.Tufts Med Ctr, Dept Internal Med, Div Nephrol, Boston, MA 02111 USA. (författare)
  • Chang, Alex R.Geisinger Hlth Syst, Div Nephrol, Danville, PA USA. (författare)
  • McAdams-DeMarco, MaraJohns Hopkins Bloomberg Sch Publ Hlth, Dept Epidemiol, Baltimore, MD 21205 USA.;Johns Hopkins Univ, Sch Med, Dept Surg, Baltimore, MD 21205 USA. (författare)
  • Grams, Morgan E.Johns Hopkins Bloomberg Sch Publ Hlth, Dept Epidemiol, Baltimore, MD 21205 USA.;Johns Hopkins Univ, Sch Med, Dept Med, Baltimore, MD 21205 USA. (författare)
  • Shin, Jung-ImJohns Hopkins Bloomberg Sch Publ Hlth, Dept Epidemiol, Baltimore, MD 21205 USA. (författare)
  • Carrero, Juan J.Karolinska Institutet (författare)
  • Karolinska Inst, Dept Med Epidemiol & Biostat, Stockholm, Sweden.Johns Hopkins Bloomberg Sch Publ Hlth, Dept Epidemiol, Baltimore, MD 21205 USA. (creator_code:org_t)

Sammanhörande titlar

  • Ingår i:Clinical Kidney Journal: Oxford University Press (OUP)15:3, s. 442-4512048-85052048-8513

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