Risk of Acute Kidney Injury and Long-Term Outcome in Patients With Acetaminophen Intoxication

Chen, Yuguang; Lin, Cheng‐Li; Dai, Ming‐Shen; Chang, Ping‐Ying; Chen, Jiahong; Huang, Tseng; Wu, Yi-Ying; Kao, Chia‐Hung

doi:10.1097/md.0000000000002040

Cited by 30 publications

(34 citation statements)

References 15 publications

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“…15 The NHIRD details have been adequately described in previous highly cited papers. 16 , 17 To ensure patient privacy, patient identification numbers are scrambled before the files are released for research. Diseases were defined according to the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes.…”

Section: Methodsmentioning

confidence: 99%

Leptospirosis and Peripheral Artery Occlusive Disease

Chiu

Lin²,

Lee

et al. 2016

Medicine

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Data on the association between peripheral artery occlusive disease (PAOD) and leptospirosis are limited. We conducted a retrospective cohort study for determining whether leptospirosis is one of the possible risk factors for PAOD.Patients diagnosed with leptospirosis by using 2000 to 2010 data from the Taiwan National Health Insurance Research Database. Patients with leptospirosis without a history of PAOD were selected. For each leptospirosis patient, 4 controls without a history of leptospirosis and PAOD were randomly selected and frequency-matched for sex, age, the year of the index date, and comorbidity diseases. The follow-up period was from the time of the initial diagnosis of leptospirosis to the diagnosis date of PAOD, or December 31, 2011. The Cox proportional hazard regression models were used for analyzing the risk of PAOD.During the follow-up period, the cumulative incidence of PAOD was higher among the patients from the leptospirosis cohort than among the nonleptospirosis cohort (log-rank test, P < .001). In total, 29 patients with PAOD from the leptospirosis cohort and 81 from the nonleptospirosis cohort were observed with the incidence rates of 2.1 and 1.3 per 1000 person-years, respectively, yielding a crude hazards ratio (HR) of 1.62 (95% confidence interval [CI] = 1.44–1.81) and adjusted HR (aHR) of 1.75 (95% CI = 1.58–1.95).The risk of PAOD was 1.75-fold higher in the patients with leptospirosis than in the general population.

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Section: Methodsmentioning

confidence: 99%

Leptospirosis and Peripheral Artery Occlusive Disease

Chiu

Lin²,

Lee

et al. 2016

Medicine

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“…Previous case reports 2 - 4 and cohort studies 5 , 6 have suggested an association between supratherapeutic doses of APAP and AKI. To our knowledge, there is only one case series 7 that reported two AKI cases suspiciously induced by therapeutic-dose APAP.…”

Section: Introductionmentioning

confidence: 91%

Acetaminophen administration and the risk of acute kidney injury: a self-controlled case series study

Hiragi¹,

Yamada²,

Tsukamoto³

et al. 2018

CLEP

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BackgroundAcetaminophen (APAP) is frequently used for analgesia and is considered safer than nonsteroidal anti-inflammatory drugs (NSAIDs) for the kidneys. However, there is little epidemiological evidence of the association between APAP and acute kidney injury (AKI).ObjectivesTo examine the association between APAP and AKI using the self-controlled case series (SCCS) method, which is a novel strategy to control between-person confounders by comparing the risk and reference periods in each patient.MethodsWe performed SCCS in 1,871 patients (39.9% female) who were administered APAP and subsequently developed AKI, by reviewing electronically stored hospital information system data from May 2011 to July 2016. We used conditional Poisson regression to compare each patient’s risk and reference period. As a time-varying confounder, we adjusted the status of liver and kidney functions, systemic inflammation, and exposure to NSAIDs.ResultsWe identified 5,650 AKI events during the 260,549 person-day observation period. The unadjusted incidences during the reference and exposure periods were 2.01/100 and 3.12/100 person-days, respectively. The incidence rate ratio adjusted with SCCS was 1.03 (95% confidence interval [CI]: 0.95–1.12). When we restricted endpoints as stage 2 AKI- and stage 3 AKI-level creatinine elevations, the incidence rate ratios were 1.20 (95% CI 0.91–1.58) and 1.20 (95% CI 0.62–2.31), respectively, neither of which was statistically significant.ConclusionOur findings added epidemiological information for the relationship between APAP administration and AKI development. The results indicated scarce association between APAP and AKI, presumably supporting the general physicians’ impression that APAP is safer for kidney.

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“…При передозировке ПАР способен вызывать тяжелое поражение почек [32,33]. Но при использовании его терапевтических доз риск почечных осложнений, по-видимому, достаточно низкий.…”

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Analgesic therapy and a problem of comorbidity

Каратеев¹

2019

Sovremennaâ revmatologiâ

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Одним из центральных направлений улучшения качества медицинской помощи является реализация концепции персонифицированной медицины, которая подразумевает комплексный индивидуальный подход к лечению, направленный на максимально полное восстановление здоровья, качества жизни и социальной активности пациента. Согласно данной концепции, при проведении терапии следует учитывать не только конкретные клинические проявления болезни, но и особенности ее течения (фенотип), различия в «ответе» на лекарственные препараты (что определяется, в частности, генетическим полиморфизмом ферментных систем, участвующих в метаболизме ксенобиотиков), а также наличие коморбидной патологии [1-3]. Именно коморбидный фон во многом определяет общее состояние здоровья пациента и возможности проведения активной фармакотерапии. Ведь именно коморбидные заболевания и патологические состояния являются главными факторами риска развития нежелательных реакций (НР), связанных с использованием тех или иных лекарственных средств. Данная проблема представляется особенно важной для ревматологической практики, поскольку про-тиворевматические препараты способны оказывать серьезное негативное влияние на состояние многих органов и систем организма [2, 4, 5]. В последние годы был опубликован ряд крупных работ, показавших большую распространенность коморбидных состояний при ревматических заболеваниях (РЗ). Так, в исследовании COMORA, в котором приняли участие ученые из 17 стран (в том числе из России), оценивалась частота коморбидных заболеваний у 3920 больных ревматоидным артритом (РА). Было отмечено, что 15% пациентов страдали депрессией, 12% имели в анамнезе язвы желудка и/или двенадцатиперстной кишки (ДПК), 6,6%-бронхиальную астму, а 6,0%-инфаркт миокарда (ИМ) и/или ишемический инсульт (ИИ) [6]. Весьма показательны данные J. An и соавт. [7], которые сравнивали коморбидный фон у 2925 пациентов с РА и 14 625 пациентов без этого заболевания. Оказалось, что 3 и более коморбидных заболеваний имели 60,4% больных РА и 37,2% лиц контрольной группы; 5 и более таких заболеваний-23,5 и 12,0% соответственно. Наиболее часто при РА встречались кардиоваскулярные (79,0%) и респираторные болезни (34,4%). Наличие 5 и более коморбид

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Risk of Acute Kidney Injury and Long-Term Outcome in Patients With Acetaminophen Intoxication

Cited by 30 publications

References 15 publications

Leptospirosis and Peripheral Artery Occlusive Disease

Leptospirosis and Peripheral Artery Occlusive Disease

Acetaminophen administration and the risk of acute kidney injury: a self-controlled case series study

Analgesic therapy and a problem of comorbidity

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