Second-generation antipsychotics and the risk of chronic kidney disease: a population-based case-control study
Objectives To examine the association between use of second-generation antipsychotics (SGA) and the risk of chronic kidney disease (CKD).Design Population-based case-control study.Setting Routinely collected laboratory, prescription and diagnostic information on all inhabitants with creatinine measu...
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| Format: | Article |
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BMJ Publishing Group
2020-08-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/10/8/e038247.full |
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| author | Daniel Pilsgaard Henriksen Per Damkier Mikkel Højlund Lars Christian Lund Jonas Leander Emming Herping Maija Bruun Haastrup |
| author_facet | Daniel Pilsgaard Henriksen Per Damkier Mikkel Højlund Lars Christian Lund Jonas Leander Emming Herping Maija Bruun Haastrup |
| author_sort | Daniel Pilsgaard Henriksen |
| collection | DOAJ |
| description | Objectives To examine the association between use of second-generation antipsychotics (SGA) and the risk of chronic kidney disease (CKD).Design Population-based case-control study.Setting Routinely collected laboratory, prescription and diagnostic information on all inhabitants with creatinine measurements residing on the island of Funen, Denmark (2001 to 2015).Participants 21 434 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 measures CKD 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.Results Use 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).Conclusion Use 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. |
| format | Article |
| id | doaj-art-7caa4cf7b83b4a51a879eccb86e23bc7 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2020-08-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-7caa4cf7b83b4a51a879eccb86e23bc72024-12-03T04:10:09ZengBMJ Publishing GroupBMJ Open2044-60552020-08-0110810.1136/bmjopen-2020-038247Second-generation antipsychotics and the risk of chronic kidney disease: a population-based case-control studyDaniel Pilsgaard Henriksen0Per Damkier1Mikkel Højlund2Lars Christian Lund3Jonas Leander Emming Herping4Maija Bruun Haastrup5Department of Clinical Pharmacology, Odense University Hospital, Odense, Denmark3 Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark1 Clinical Pharmacology and Pharmacy, Department of Public Health, University of Southern Denmark, Odense, Denmarkpostdoctoral researcher1 Clinical Pharmacology and Pharmacy, Department of Public Health, University of Southern Denmark, Odense, Denmark3 Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, DenmarkObjectives To examine the association between use of second-generation antipsychotics (SGA) and the risk of chronic kidney disease (CKD).Design Population-based case-control study.Setting Routinely collected laboratory, prescription and diagnostic information on all inhabitants with creatinine measurements residing on the island of Funen, Denmark (2001 to 2015).Participants 21 434 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 measures CKD 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.Results Use 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).Conclusion Use 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.https://bmjopen.bmj.com/content/10/8/e038247.full |
| spellingShingle | Daniel Pilsgaard Henriksen Per Damkier Mikkel Højlund Lars Christian Lund Jonas Leander Emming Herping Maija Bruun Haastrup Second-generation antipsychotics and the risk of chronic kidney disease: a population-based case-control study BMJ Open |
| title | Second-generation antipsychotics and the risk of chronic kidney disease: a population-based case-control study |
| title_full | Second-generation antipsychotics and the risk of chronic kidney disease: a population-based case-control study |
| title_fullStr | Second-generation antipsychotics and the risk of chronic kidney disease: a population-based case-control study |
| title_full_unstemmed | Second-generation antipsychotics and the risk of chronic kidney disease: a population-based case-control study |
| title_short | Second-generation antipsychotics and the risk of chronic kidney disease: a population-based case-control study |
| title_sort | second generation antipsychotics and the risk of chronic kidney disease a population based case control study |
| url | https://bmjopen.bmj.com/content/10/8/e038247.full |
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