Loop Diuretics Are Associated with Increased Risk of Hospital-Acquired Acute Kidney Injury in Adult Patients: A Retrospective Study.
Loop Diuretics Are Associated with Increased Risk of Hospital-Acquired Acute Kidney Injury in Adult Patients: A Retrospective Study.
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袢利尿剂与成年患者院内获得性急性肾损伤风险增加相关：一项回顾性研究
DOI：
10.3390/jcm11133665
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发表时间：
2022-06-24
影响因子：
3.9
通讯作者：
中科院分区：
文献类型：
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作者：
背景：袢利尿剂与急性肾损伤（AKI）之间的关联仍不清楚。方法：研究人群选自中国住院患者AKI流行病学（EACH）研究。袢利尿剂暴露定义为在 HA-AKI 患者中检测到 AKI 之前以及在无 AKI 患者中最后一次 SCr 检测日期之前服用的任何处方。结果是 AKI，由肾脏病改善全球结果标准定义。通过针对基线和时间依赖性协变量进行调整的 Cox 比例风险模型检查了袢利尿剂与 HA-AKI 之间的关联。结果：在 150,020 名患者中，16,437 名患者（11.0%）服用了袢利尿剂，5717 名患者（3.8%）经历了 HA-AKI 事件。服用袢利尿剂和未服用袢利尿剂的患者中，HA-AKI 的粗发生率分别为 1632 例（9.9%）和 3262 例（2.8%）。多变量 Cox 比例风险分析显示，与未使用者相比，接触袢利尿剂与 HA-AKI 风险显着增加相关（风险比 (HR)，1.61；95% CI（置信区间），1.55–1.67）、其他利尿剂（HR，1.09；95% CI，1.03–1.15）和渗透性利尿剂（HR， 1.30；95% CI，1.20-1.42）。与其他利尿剂相比，使用袢利尿剂与女性、无高血压患者、无心力衰竭患者、无肝硬化患者和不需要手术的患者发生HA-AKI的风险较高相关。结论：袢利尿剂广泛使用，并且与住院成人 HA-AKI 风险增加相关。使用袢利尿剂期间应更密切地监测肾功能。
Background: The association between loop diuretics and acute kidney injury (AKI) remains unclear. Methods: The population studied was selected from the Epidemiology of AKI in Chinese Hospitalized patients (EACH) study. Exposure to loop diuretics was defined as any filled prescription prior to the date when AKI was detected in patients with HA-AKI, and prior to the last date of SCr testing in those without AKI. The outcome was AKI, defined by the Kidney Disease Improving Global Outcomes criteria. Associations between loop diuretics and HA-AKI were examined by Cox proportional hazards models adjusted for baseline and time-dependent covariates. Results: Of the 150,020 patients, 16,437 (11.0%) were prescribed loop diuretics, and 5717 (3.8%) experienced HA-AKI events. The crude rates of HA-AKI in patients who were and were not prescribed loop diuretics were 1632 (9.9%) and 3262 (2.8%), respectively. A multivariate cox proportional hazards analysis showed that exposure to loop diuretics was associated with significantly increased risks of HA-AKI compared with non-users (hazard ratio (HR), 1.61; 95% CI (confidence interval), 1.55–1.67), other diuretics (HR, 1.09; 95% CI, 1.03–1.15), and osmotic diuretics (HR, 1.30; 95% CI, 1.20–1.42). Compared with other diuretics, the use of loop diuretics was associated with higher risks of HA-AKI in women, in patients without hypertension, in patients without heart failure, in patients without liver cirrhosis, and in patients not requiring surgery. Conclusions: Loop diuretics are widely used and are associated with increased risks of HA-AKI in hospitalized adults. Renal function should be more closely monitored during the use of loop diuretics.
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影响因子：
15.8
作者：
Selby NM;Fluck RJ;Kolhe NV;Taal MW
通讯作者：
Taal MW
影响因子：
6.2
作者：
Li, Philip Kam Tao;Burdmann, Emmanuel A.;Mehta, Ravindra L.
通讯作者：
Mehta, Ravindra L.
DOI：
10.1590/s0100-879x2012007500093
发表时间：
2012-09
期刊：
Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologicas
影响因子：
--
作者：
Levi TM;Rocha MS;Almeida DN;Martins RT;Silva MG;Santana NC;Sanjuan IT;Cruz CM
通讯作者：
Cruz CM
DOI：
10.2215/cjn.00710113
发表时间：
2013-09-06
影响因子：
9.8
作者：
Susantitaphong, Paweena;Cruz, Dinna N.;Jaber, Bertrand L.
通讯作者：
Jaber, Bertrand L.
影响因子：
4.6
作者：
Roberts G;Phillips D;McCarthy R;Bolusani H;Mizen P;Hassan M;Hooper R;Saddler K;Hu M;Lodhi S;Toynton E;Geen J;Lodhi V;Grose C;Phillips A
通讯作者：
Phillips A