Second-generation antipsychotic medications and risk of chronic kidney disease in schizophrenia: population-based nested case–control study

ObjectivesTo examine the association between use of second-generation antipsychotics (SGA) and the risk of chronic kidney disease (CKD).DesignPopulation-based case-control study.SettingRoutinely collected laboratory, prescription and diagnostic information on all inhabitants with creatinine measurements residing on the island of Funen, Denmark (2001 to 2015).Participants21 434 cases with incident CKD matched with 85 576 CKD-free population controls by risk-set sampling using age, sex and calendar year.Primary and secondary outcome measuresCKD was defined as an estimated glomerular filtration rate below 60 mL/min/1.73 m2 in a period longer than 3 months. Information on drug exposure and comorbidities were obtained from the Danish National Prescription Register and the Danish National Patient Register. We calculated OR for the association between SGA use and CKD using conditional logistic regression.ResultsUse of SGAs was associated with increased risk of CKD among ever users (OR 1.24, 95% CI: 1.12 to 1.37) and current users (OR 1.26, 95% CI: 1.12 to 1.42). We found no clear evidence of dose-response relationship. Both short duration (one to two antipsychotic prescriptions; OR 1.22, 95% CI: 1.01 to 1.48) as well as long-term use (>30 prescriptions; OR 1.45, 95% CI 1.19 to 1.76) were associated with an increased risk of CKD. Both use of SGAs with mild and high risk of metabolic disturbances was associated with increased risk of CKD (OR 1.21, 95% CI: 1.06 to 1.39 and OR 1.36, 95% CI: 1.11 to 1.68, respectively). Recent use of non-steroidal anti-inflammatory drugs, prior use of lithium, hypertension or prior acute kidney injury were not clearly associated with development of CKD connected to SGA exposure. The highest risk of CKD was found for clozapine (OR 1.81, 95% CI: 1.22 to 2.69).ConclusionUse of SGA is associated with a small-to-moderately increased risk of incident CKD. All investigated SGAs, except for aripiprazole, were associated with an increased risk of CKD.

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Association of Individual Non-Steroidal Anti-Inflammatory Drugs and Chronic Kidney Disease: A Population-Based Case Control Study

PLoS ONE ◽

10.1371/journal.pone.0122899 ◽

2015 ◽

Vol 10 (4) ◽

pp. e0122899 ◽

Cited By ~ 35

Author(s):

Ylenia Ingrasciotta ◽

Janet Sultana ◽

Francesco Giorgianni ◽

Andrea Fontana ◽

Antonio Santangelo ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Case Control Study ◽

Population Based ◽

Case Control ◽

Inflammatory Drugs ◽

Anti Inflammatory ◽

Control Study

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Lactic acidosis associated with metformin in patients with moderate to severe chronic kidney disease: study protocol for a multicenter population-based case-control study using health databases

BMC Nephrology ◽

10.1186/s12882-019-1389-8 ◽

2019 ◽

Vol 20 (1) ◽

Author(s):

Consuelo Pedrós ◽

◽

Mónica Ávila ◽

Ainhoa Gómez-Lumbreras ◽

Marcela Manríquez ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Lactic Acidosis ◽

Study Protocol ◽

Case Control Study ◽

Population Based ◽

Case Control ◽

Severe Chronic Kidney Disease ◽

Disease Study ◽

Control Study

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Lactic acidosis incidence with metformin in patients with type 2 diabetes and chronic kidney disease: A retrospective nested case-control study

Endocrinology Diabetes & Metabolism ◽

10.1002/edm2.170 ◽

2020 ◽

pp. e00170

Author(s):

Carlos A. Alvarez ◽

Ethan A. Halm ◽

Mary Jo V. Pugh ◽

Darren K. McGuire ◽

Sean Hennessy ◽

...

Keyword(s):

Type 2 Diabetes ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Lactic Acidosis ◽

Case Control Study ◽

Case Control ◽

Nested Case Control ◽

Control Study

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Novel Oral Anticoagulants and the Risk of Major Hemorrhage in Elderly Patients With Chronic Kidney Disease: A Nested Case-Control Study

Canadian Journal of Cardiology ◽

10.1016/j.cjca.2016.01.013 ◽

2016 ◽

Vol 32 (8) ◽

pp. 986.e17-986.e22 ◽

Cited By ~ 12

Author(s):

Ziv Harel ◽

Muhammad Mamdani ◽

David N. Juurlink ◽

Amit X. Garg ◽

Ron Wald ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Elderly Patients ◽

Case Control Study ◽

Oral Anticoagulants ◽

Case Control ◽

Novel Oral Anticoagulants ◽

Major Hemorrhage ◽

Nested Case Control ◽

Control Study

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Chronic Kidney Disease Mortality Among Farmers From Brazil: A Population-Based Case-Control Study

ISEE Conference Abstracts ◽

10.1289/isee.2015.2015-1048 ◽

2015 ◽

Vol 2015 (1) ◽

pp. 1048

Author(s):

Adalberto L. Miranda-Filho ◽

Samantha Serrano ◽

Carmen Freire ◽

Gina Torres Rego Monteiro

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Case Control Study ◽

Population Based ◽

Case Control ◽

Disease Mortality ◽

Control Study

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Prevalence of Hyperkalemia in Diabetic and Non-Diabetic Patients with Chronic Kidney Disease: A Nested Case-Control Study

American Journal of Nephrology ◽

10.1159/000442393 ◽

2015 ◽

Vol 42 (5) ◽

pp. 351-360 ◽

Cited By ~ 16

Author(s):

Charalampos Loutradis ◽

Panagiota Tolika ◽

Alexandra Skodra ◽

Afroditi Avdelidou ◽

Pantelis A. Sarafidis

Keyword(s):

Chronic Kidney Disease ◽

Renal Function ◽

Kidney Disease ◽

Case Control Study ◽

Case Control ◽

Diabetic Patients ◽

Sodium Polystyrene Sulfonate ◽

Stage 4 ◽

Nested Case Control ◽

Control Study

Background: Hyperkalemia is a potentially life-threatening disorder, usually complicating chronic kidney disease (CKD). Factors superimposed to reduced renal function are further elevating hyperkalemia risk, but their contribution is not fully elucidated. This study aimed to compare the prevalence of hyperkalemia in diabetic and non-diabetic patients with CKD. Methods: This is a nested case-control study of 180 type-2 diabetic and 180 non-diabetic patients with CKD followed in a Nephrology outpatient clinic, matched for gender, age and estimated glomerular filtration rate. Type-1 diabetes or end-stage renal disease patients were excluded. Prevalence of hyperkalemia was defined as potassium >5 mEq/l or use of sodium polystyrene sulfonate, and further by potassium >5, ≥5.2 and ≥5.5 mEq/l. It was calculated in both groups in whole and CKD stages separately. Univariate and multivariate logistic regression analysis were conducted to identify factors associated with hyperkalemia. Results: The prevalence of hyperkalemia was higher in diabetic CKD patients (27.2 vs. 20%, p = 0.107) and remained around 30% higher with all secondary definitions used, but never reached statistical significance. In Stage 2, no difference was noted (8.7 vs. 17.4%, p = 0.665); in Stage 3, it was significantly higher in diabetics (28.6 vs. 17.5%, p = 0.036); and in Stage 4, it was equally high in both groups (35.5 vs. 32.3%, p = 0.788). In multivariate analysis, Stage 4 CKD (OR 4.535, 95% CI 1.561-13.173), use of angiotensin-converting enzyme inhibitors (ACEIs; OR 2.228, 95% CI 1.254-3.958) and smoking (OR 2.254, 95% CI 1.218-4.171) were independently associated with hyperkalemia. Conclusions: Diabetes mellitus was found to elevate the prevalence of hyperkalemia only in CKD Stage 3 patients (moderately impaired renal function). Advanced CKD at Stage 4 and ACEIs are major determinants of hyperkalemia occurrence.

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