Risk of acute kidney injury in patients with HIV receiving proton pump inhibitors

2019 ◽  
Vol 8 (10) ◽  
pp. 781-790
Author(s):  
S Scott Sutton ◽  
Joseph Magagnoli ◽  
Tammy H Cummings ◽  
James W Hardin
Keyword(s):  
Acute Kidney Injury ◽  
Cohort Study ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Kidney Injury ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Increased Risk

Aims/patients & methods: To evaluate the risk of acute kidney injury (AKI) in patients with HIV receiving proton pump inhibitors (PPI) a cohort study was conducted utilizing the Veterans Affairs Informatics and Computing Infrastructure (VINCI) database. Patients were followed from the index date until the earliest date of AKI, 120 days or end of study period, or death. Statistical analyses utilized a Cox proportional hazards model. Results: A total of 21,643 patients (6000 PPI and 15,643 non-PPI) met all study criteria. The PPI cohort had twice the risk of AKI compared with controls (2.12, hazard ratio: 1.46–3.1). Conclusion: A nationwide cohort study supported the relationship of an increased risk of AKI in patients receiving PPIs.

scholarly journals Association of Increased Risk of Pneumonia and Using Proton Pump Inhibitors in Patients With Type II Diabetes Mellitus

Dose-Response ◽  
2019 ◽  
Vol 17 (2) ◽  
pp. 155932581984338 ◽  
Author(s):  
Wen-Ling Lin ◽  
Chin-Shin Muo ◽  
Wen-Chuan Lin ◽  
Yow-Wen Hsieh ◽  
Chia-Hung Kao
Keyword(s):  
Diabetes Mellitus ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Defined Daily Dose ◽  
Defined Daily Doses ◽  
Increased Risk

Background: This study explored the possible association between the use of proton pump inhibitors (PPIs) and the increased incidence of pneumonia in patients with type 2 diabetes mellitus (T2DM). Methods: We selected 4940 patients with T2DM of whom 988 and 3952 were enrolled in PPI and propensity score-matched control cohorts, respectively. All patients were followed from the index date until admission with pneumonia, withdrawal from the National Health Insurance program or the end of 2013. The PPIs associated with risk of incident pneumonia were examined. Furthermore, we assessed the risk of pneumonia according to annual defined daily doses in the PPI cohort. Results: After a 14-year follow-up, the cumulative incidence of pneumonia in the PPI users was 11.4% higher than that in the controls (30.3% vs 18.9%). Compared to the controls, the PPI users had a 1.70-fold higher risk of pneumonia in the Cox proportional hazards model after adjustment for matched pairs. The risk of pneumonia increased with the annual PPI defined daily dose. Conclusion: The results of this population-based retrospective cohort study suggest that PPI use increased the risk of pneumonia in patients with T2DM. The effects were more prominent in patients administered higher doses of PPIs.

scholarly journals Effect of multiple episodes of acute kidney injury on mortality: an observational study

2020 ◽  
Author(s):  
Heather Walker ◽  
Nicosha De Souza ◽  
Simona Hapca ◽  
Miles D Witham ◽  
Samira Bell
Keyword(s):  
Acute Kidney Injury ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Kidney Injury ◽  
Patient Characteristics ◽  
Cox Proportional Hazards ◽  
Hazard Ratio ◽  
Cox Proportional Hazards Model ◽  
Hazards Model ◽  
Increased Risk

Abstract Background Patients who survive an episode of acute kidney injury (AKI) are more likely to have further episodes of AKI. AKI is associated with increased mortality, with a further increase with recurrent episodes. It is not clear whether this is due to AKI or as a result of other patient characteristics. The aim of this study was to establish whether recurrence of AKI is an independent risk factor for mortality or if excess mortality is explained by other factors. Methods This observational cohort study included adult people from the Tayside region of Scotland, with an episode of AKI between 1 January 2009 and 31 December 2009. AKI was defined using the creatinine-based Kidney Disease: Improving Global Outcomes definition. Associations between recurrent AKI and mortality were examined using a Cox proportional hazards model. Results Survival was worse in the group identified to have recurrent AKI compared with those with a single episode of AKI [hazard ratio = 1.49, 95% confidence interval (CI) 1.37–1.63; P < 0.001]. After adjustment for comorbidities, stage of reference AKI, sex, age, medicines that predispose to renal impairment or, in the 3 months prior to the reference AKI, deprivation and baseline estimated glomerular filtration rate (eGFR), recurrent AKI was independently associated with an increase in mortality (hazard ratio = 1.25, 95% CI 1.14–1.37; P < 0.001). Increasing stage of reference AKI, age, deprivation, baseline eGFR, male sex, previous myocardial infarction, cerebrovascular disease and diuretic use were all associated with an increased risk of mortality in patients with recurrent AKI. Conclusions Recurrent AKI is associated with increased mortality. After adjusting for patient characteristics, the increase in mortality is independently associated with recurrent AKI and is not solely explained by other risk factors.

scholarly journals The Association between the Use of Proton Pump Inhibitors and the Risk of Hypomagnesemia in a National Cohort of Veteran Patients with HIV

2019 ◽  
Vol 18 ◽  
pp. 232595821882165 ◽  
Author(s):  
S. Scott Sutton ◽  
Joseph Magagnoli ◽  
Tammy Cummings ◽  
James W. Hardin
Keyword(s):  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Serum Magnesium ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Hiv Positive ◽  
Hazards Model ◽  
National Cohort

Objectives: To examine the risk of hypomagnesemia of HIV-positive patients adherent to proton pump inhibitors (PPIs). Methods: A cohort study utilizing the Veterans Affairs Informatics and Computing Infrastructure was conducted on patients with (1) a complete antiretroviral therapy, (2) a serum magnesium measure during the study period, and (3) adherent to PPIs. Statistical analyses evaluated baseline characteristics between cohorts and a Cox proportional hazards model evaluating the association of hypomagnesemia while adjusting for baseline covariates. Results: A total of 6047 patients met the study inclusion criteria, 329 patients in the PPI cohort and 5718 patients in the non-PPI cohort. The stratified Cox proportional hazards model results revealed that the risk of hypomagnesemia for the PPI cohort is 3.16 times higher compared to the non-PPI cohort (adjusted hazard ratio = 3.16, 95% confidence interval = 2.56-3.9). Conclusions: Proton pump inhibitors medication usage in HIV-positive patients is associated with a higher risk of hypomagnesemia compared to non-PPI patients.

scholarly journals Association Between Base Excess and Mortality Among Patients in ICU with Acute Kidney Injury

2021 ◽  
Author(s):  
Yi Cheng ◽  
Yuanjun Tang ◽  
Boxiang Tu ◽  
Xin Cheng ◽  
Ran Qi ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Medical Information ◽  
Proportional Hazards ◽  
Base Excess ◽  
Proportional Hazards Model ◽  
Kidney Injury ◽  
Prognostic Indicator ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Icu Patients

Abstract Objective This study aimed to explore the association between base excess (BE) and risk of 30-day mortality among patients with acute kidney injury (AKI) in ICU.Methods This retrospective study including ICU patients with AKI from Medical Information Mart for Intensive Care (MIMIC)-IV database. We used multivariate Cox proportional-hazards model to calculate the hazard ratio (HR) for risk of 30-day mortality among patients with AKI. Furthermore, we utilized Cox proportional-hazard model with restrict cubic splines (RCS) to explore the potential no-linear association. Results Of all the 14238 ICU patients with AKI, BE showed U-shaped relationship with risk of 30-day mortality for patients with AKI, and higher or lower BE value could increase the risk. Compared with normal base excess (-3~3 mmol/L), patients with difference groups (BE ≤ -9mmol/L, -9 mmol/L <BE≤-3 mmol/L, 3 mmol/L <BE≤9 mmol/L and BE＞9 mmol/L) had different HR for mortality: 1.57(1.40,1.76), 1.26(1.14,1.39), 0.97(0.83,1.12), 1.53(1.17,2.02) respectively. And the RCS analyses also showed U-shaped curve between BE and 30-day mortality risk.Conclusion Our results suggest both higher and lower BE in patients with AKI would increase the risk of 30-day mortality. BE measured at administration could be a critical prognostic indicator for ICU patients with AIK and provide guidance for clinicians.

Abstract P390: Relationship between BMI and Risk of Hypertension in an urban Japanese cohort study: the Suita study

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Michikazu Nakai ◽  
Makoto Watanabe ◽  
Kunihiro Nishimura ◽  
Misa Takegami ◽  
Yoshihiro Kokubo ◽  
...  
Keyword(s):  
Cohort Study ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Men And Women ◽  
Japanese Cohort ◽  
Hazards Model ◽  
Increased Risk

Objective: The positive relation between body mass index (BMI) and risk of incident hypertension (HT) has been reported mainly in the Western subjects with high BMI. However, there are a few reports in the Asian with relatively lower BMI. This study investigated the relation of BMI with risk of incident HT in the population-based prospective cohort study of Japan, the Suita study. Methods: Participants who had no HT at baseline (1,591 men and 1,973 women) aged 30-84 years were included in this study. BMI categories were defined as following: underweight (BMI<18.5), normal (18.5≤BMI<25.0), and overweight (BMI ≥ 25.0). The Cox proportional hazards model was used to estimate hazard ratios (HRs) of BMI categories for incident HT by sex. HRs were adjusted for age, cigarette smoking and alcohol drinking. The HRs according to quartiles of BMI were also estimated, using the lowest quartile of BMI as a reference. Results: During median follow-up of 7.2 years, 1,325 participants (640 men and 685 women) developed HT. The HR (95% CI) of 1kg/m2 increment of BMI for HT in men and women was 1.08 (1.05-1.11) and 1.10 (1.07-1.12), respectively. When we set a normal BMI as a reference, HR of overweight BMI in men and women was 1.37 (1.13-1.67) and 1.45 (1.18-1.77), whereas HR of underweight BMI in men and women was 0.63 (0.45-0.90) and 0.60 (0.45-0.80), respectively. In addition, compared to the lowest quartile, HR of the highest quartile of BMI in men and women was 1.67 (1.33-2.10, trend p<0.001) and 2.10 (1.67-2.64, trend p<0.001), respectively. Conclusion: In this study, we showed that higher BMI was associated with increased risk of hypertension in both Japanese men and women.

Cause-Specific Survival for Women Diagnosed With Cancer During Pregnancy or Lactation: A Registry-Based Cohort Study

2009 ◽  
Vol 27 (1) ◽  
pp. 45-51 ◽  
Author(s):  
Hanne Stensheim ◽  
Bjørn Møller ◽  
Tini van Dijk ◽  
Sophie D. Fosså
Keyword(s):  
Ovarian Cancer ◽  
Cohort Study ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Birth Registry ◽  
Increased Risk ◽  
Cause Specific Survival

Purpose To assess if cancers diagnosed during pregnancy or lactation are associated with increased risk of cause-specific death. Patients and Methods In this population-based cohort study using data from the Cancer Registry and the Medical Birth Registry of Norway, 42,511 women, age 16 to 49 years and diagnosed with cancer from 1967 to 2002, were eligible. They were grouped as not pregnant (reference), pregnant, or lactating at diagnosis. Cause-specific survival for all sites combined, and for the most frequent malignancies, was investigated using a Cox proportional hazards model. An additional analysis with time-dependent covariates was performed for comparison of women with and without a postcancer pregnancy. The multivariate analyses were adjusted for age at diagnosis, extent of disease, and diagnostic periods. Results For all sites combined, no intergroup differences in cause-specific death were seen, with hazard ratio (HR) of 1.03 (95% CI, 0.86 to 1.22) and HR 1.02 (95% CI, 0.86 to 1.22) for the pregnant and lactating groups, respectively. Patients with breast (HR, 1.95; 95% CI, 1.36 to 2.78) and ovarian cancer (HR, 2.23; 95% CI, 1.05 to 4.73) diagnosed during lactation had an increased risk of cause-specific death. Diagnosis of malignant melanoma during pregnancy slightly increased this risk. For all sites combined, the risk of cause-specific death was significantly decreased for women who had postcancer pregnancies. Conclusion In general, the diagnosis of most cancer types during pregnancy or lactation does not increase the risk of cause-specific death. Breast and ovarian cancer diagnosed during lactation represents an exception. We confirmed the “healthy mother effect” for women with a postcancer pregnancy.

scholarly journals Risk of pleural empyema in patients with schizophrenia: a nationwide propensity-matched cohort study in Taiwan

BMJ Open ◽  
2018 ◽  
Vol 8 (7) ◽  
pp. e021187 ◽  
Author(s):  
Te-Chun Shen ◽  
Chia-Hung Chen ◽  
Yu-Jhen Huang ◽  
Cheng-Li Lin ◽  
Ting-Chang Chang ◽  
...  
Keyword(s):  
Cohort Study ◽  
Propensity Scores ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Pleural Empyema ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Research Database ◽  
Increased Risk ◽  
Comparison Cohort

ObjectiveThoracic infection and pneumonia are prevalent in patients with schizophrenia; however, it is unclear whether patients with schizophrenia are at an increased risk of developing pleural empyema.DesignA retrospective cohort study with propensity-matched cohorts with and without schizophrenia.SettingUsing the National Health Insurance Research Database of Taiwan.ParticipantsWe identified 55 888 patients with schizophrenia newly diagnosed in 2000–2011 and same number of individuals without schizophrenia as the comparison cohort, frequency matched by propensity scores estimated using age, sex, occupation, income, urbanisation, year of diagnosis and comorbidities.Primary outcome measuresWe assessed incident pleural empyema by the end of 2011 and used the Cox proportional hazards model to calculate the schizophrenia cohort to comparison cohort HR of pleural empyema.ResultsThe overall incidence of pleural empyema was 2.44-fold greater in the schizophrenia cohort than in the comparison cohort (4.39vs1.80 per 10 000 person-years), with an adjusted HR of 2.87(95% CI 2.14 to 3.84). Stratified analyses by age, sex, occupation, income, urbanisation and comorbidity revealed significant hazards for pleural empyema associated with schizophrenia in all subgroups.ConclusionsPatients with schizophrenia are at an increased risk of developing pleural empyema and require greater attention and appropriate support.

scholarly journals Laxative use and mortality in patients on haemodialysis: a prospective cohort study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Yu Honda ◽  
Seiji Itano ◽  
Aiko Kugimiya ◽  
Eiji Kubo ◽  
Yosuke Yamada ◽  
...  
Keyword(s):  
Cohort Study ◽  
Missing Values ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Risk Of Death ◽  
Number Of Patients ◽  
Increased Risk ◽  
All Cause Mortality

Abstract Background Patients on haemodialysis (HD) are often constipated. This study aimed to assess the relationship between constipation and mortality in such patients. In this study, constipation was defined as receiving prescription laxatives, based on the investigation results of “a need to take laxatives is the most common conception of constipation” reported by the World Gastroenterology Organization Global Guidelines. Methods This cohort study included 12,217 adult patients on HD enrolled in the Japan-Dialysis Outcomes and Practice Patterns study phases 1 to 5 (1998 to 2015). The participants were grouped into two based on whether they were prescribed laxatives during enrolment at baseline. The primary endpoint was all-cause mortality in 3 years, and the secondary endpoint was cause-specific death. Missing values were imputed using multiple imputation methods. All estimations were calculated using a Cox proportional hazards model with an inverse probability of treatment weighting using the propensity score. Results Laxatives were prescribed in 30.5% of the patients, and there were 1240 all-cause deaths. There was a significant association between laxative prescription and all-cause mortality [adjusted hazard ratio (AHR), 1.12; 95% confidence interval (CI): 1.03 to 1.21]. Because the Kaplan-Meier curves of the two groups crossed over, we examined 8345 patients observed for more than 1.5 years. Laxative prescription was significantly associated with all-cause mortality (AHR, 1.35; 95% CI: 1.17 to 1.55). The AHR of infectious death was 1.62 (95% CI: 1.14 to 2.29), and that of cancerous death was 1.60 (95% CI: 1.08 to 2.36). However, cardiovascular death did not show a significant inter-group difference. Conclusions Constipation requiring use of laxatives was associated with an increased risk of death in patients on HD. It is important to prevent patients receiving HD from developing constipation and to reduce the number of patients requiring laxatives.

Long-term Kidney Outcomes Following Childhood Acute Kidney Injury Receiving Dialysis: A Population-based Cohort Study

2021 ◽  
pp. ASN.2020111665
Author(s):  
Cal Robinson ◽  
Nivethika Jeyakumar ◽  
Bin Luo ◽  
Ron Wald ◽  
Amit Garg ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Cohort Study ◽  
Kidney Failure ◽  
Proportional Hazards ◽  
Kidney Injury ◽  
Cox Proportional Hazards ◽  
Administrative Databases ◽  
Pediatric Dialysis ◽  
Increased Risk

Background Acute kidney injury (AKI) is common during pediatric hospitalizations and associated with adverse short-term outcomes. However, long-term outcomes among survivors of pediatric AKI who received dialysis remain uncertain. Methods To determine the long-term risk of kidney failure (defined as receipt of chronic dialysis or kidney transplant) or death over a 22-year period for pediatric survivors of dialysistreated AKI, we used province-wide health administrative databases to perform a retrospective cohort study of all neonates and children (aged 0-18 years) hospitalized in Ontario, Canada, from April 1, 1996, to March 31, 2017, who survived a dialysis-treated AKI episode. Each AKI survivor was matched to four hospitalized pediatric comparators without dialysis-treated AKI, based on age, sex, and admission year. We reported the incidence of each outcome and performed Cox proportional hazards regression analyses, adjusting for relevant covariates. Results We identified 1688 pediatric dialysis-treated AKI survivors (median age 5 years) and 6752 matched comparators. Among AKI survivors, 53.7% underwent mechanical ventilation and 33.6% had cardiac surgery. During a median 9.6-year follow-up, AKI survivors were at significantly increased risk of a \ composite outcome of kidney failure or death versus comparators. Death occurred in 113 (6.7%) AKI survivors, 44 (2.6%) developed kidney failure, 174 (12.1%) developed hypertension, 213 (13.1%) developed chronic kidney disease (CKD), and 237 (14.0%) had subsequent AKI. AKI survivors had significantly higher risks of developing CKD and hypertension versus comparators. Risks were greatest in the first year after discharge and gradually decreased over time. Conclusions Survivors of pediatric dialysis-treated AKI are at higher long-term risks of kidney failure, death, CKD, and hypertension, compared with a matched hospitalized cohort.

scholarly journals Association between albumin infusion and outcomes in patients with acute kidney injury and septic shock

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Chenglong Ge ◽  
Qianyi Peng ◽  
Wei Chen ◽  
Wenchao Li ◽  
Lina Zhang ◽  
...  
Keyword(s):  
Septic Shock ◽  
Acute Kidney Injury ◽  
Medical Information ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Kidney Injury ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Albumin Infusion ◽  
Hazards Model

AbstractSeptic shock with acute kidney injury (AKI) is common in critically ill patients. Our aim was to evaluate the association between albumin infusion and outcomes in patients with septic shock and AKI. Medical Information Mart for Intensive Care (MIMIC)-III was used to identify patients with septic shock and AKI. Propensity score matching (PSM) was employed to balance the baseline differences. Cox proportional hazards model, Wilcoxon rank-sum test, and logistic regression were utilized to determine the associations of albumin infusion with mortality, length of stay, and recovery of kidney function, respectively. A total of 2861 septic shock patients with AKI were studied, including 891 with albumin infusion, and 1970 without albumin infusion. After PSM, 749 pairs of patients were matched. Albumin infusion was associated with improved 28-day survival (HR 0.72; 95% CI 0.59–0.86; P = 0.002), but it was not difference in 90-day mortality between groups (HR 0.94; 95% CI 0.79–1.12; P = 0.474). Albumin infusion was not associated with the renal function recovery (HR 0.91; 95% CI 0.73–1.13; P = 0.393) in either population. Nevertheless, subgroup analysis showed that albumin infusion was distinctly associated with reduced 28-day mortality in patients with age > 60 years. The results need to be validated in more randomized controlled trials.

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