Acute kidney injury in a cohort of critical illness patients exposed to non‐steroidal anti‐inflammatory drugs

To determine whether non-steroidal anti-inflammatory drug (NSAIDs) exposure prior to intensive care unit (ICU) admission affects the development of acute kidney injury (AKI) with renal replacement therapy (RRT). An administrative database is used to establish a cohort of patients who were admitted t...

Full description

Autores:
Oliveros, Enrique
Buitrago, Giancarlo
Tipo de recurso:
Article of investigation
Fecha de publicación:
2022
Institución:
Pontificia Universidad Javeriana
Repositorio:
Repositorio Universidad Javeriana
Idioma:
spa
OAI Identifier:
oai:repository.javeriana.edu.co:10554/63790
Acceso en línea:
https://www.mdpi.com/1424-8247/15/11/1409
http://hdl.handle.net/10554/63790
https://doi.org/10.3390/ph15111409
Palabra clave:
Nefrotoxicidad
Fármacos antiinflamatorios no esteroideos
Lesión renal aguda (IRA)
Enfermedad crítica
Control negativo
Nephrotoxicity
Non-steroidal anti-inflammatory drugs
Acute kidney injury (AKI)
Critical illness
Negative control
Rights
License
Atribución-NoComercial 4.0 Internacional
Description
Summary:To determine whether non-steroidal anti-inflammatory drug (NSAIDs) exposure prior to intensive care unit (ICU) admission affects the development of acute kidney injury (AKI) with renal replacement therapy (RRT). An administrative database is used to establish a cohort of patients who were admitted to the ICU. The exposure to NSAIDs that the patients had before admission to the ICU is determined. Demographic variables, comorbidities, AKI diagnoses requiring RRT, and pneumonia during the ICU stay are also measured. Multivariate logistic regression and inverse probability weighting (IPW) are used to calculate risks of exposure to NSAIDs for patients with AKI requiring RRT. In total, 96,235 patients were admitted to the ICU, of which 16,068 (16.7%) were exposed to NSAIDs. The incidence of AKI with RRT was 2.71% for being exposed to NSAIDs versus 2.24% for those not exposed (p < 0.001). For the outcome of AKI, the odds ratio weighted with IPW was 1.28 (95% CI: 1.15–1.43), and for the outcome of pneumonia as a negative control, the odds ratio was 1.07 (95% CI: 0.98–1.17). The impact of prior exposure to NSAIDs over critically ill patients in the development of AKI is calculated as 8 patients per 1000 exposures. The negative control with the same sources of bias did not show an association with NSAID exposure.