Benzodiazepine use and mortality of incident dialysis patients in the United States
Benzodiazepine use and mortality of incident dialysis patients in the United States
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DOI：
10.1038/sj.ki.5002548
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发表时间：
2007-12-01
影响因子：
19.6
通讯作者：
Wang, P. S.
中科院分区：
文献类型：
--
作者：
Winkelmayer, W. C.;Mehta, J.;Wang, P. S.
苯二氮卓类药物和其他omega-受体激动剂常用于治疗睡眠障碍和焦虑症。我们从全国透析发病率和死亡率研究第二波数据队列中3690例患者的记录中研究了苯二氮卓类药物和唑吡坦单独使用的比率、相关性和安全性。我们评估了药物使用和药物使用与全因死亡率之间的关系。总体而言，14%的透析患者使用苯二氮卓类药物或唑吡坦。女性、白种人、当前吸烟者和慢性阻塞性肺疾病患者更有可能使用这些药物，而脑血管疾病患者则不太可能使用这些药物。在校正分析中，苯二氮卓类药物或唑吡坦的使用与15%的高死亡率相关。慢性阻塞性肺疾病显著改变了这种关联，表明这些患者的风险更高。未发现苯二氮卓类药物的使用与髋部骨折风险增加之间存在关联。我们得出结论，苯二氮卓类药物或唑吡坦的使用在意外透析患者中很常见，并且可能与更高的死亡率相关。需要进一步的研究来阐明这些药物在透析人群中的安全性，这可能导致在透析患者中谨慎和限制性地使用ω -受体激动剂。
Benzodiazepines and other omega-receptor agonists are frequently used for sleep and anxiety disorders. We studied the rates, correlates, and safety of individual benzodiazepines and zolpidem use from the records of 3690 patients in a national cohort of Dialysis Morbidity and Mortality Study Wave 2 data. We assessed drug utilization and an association between drug use and all-cause mortality. Overall, 14% of incident dialysis patients used a benzodiazepine or zolpidem. Women, Caucasians, current smokers, and patients with chronic obstructive pulmonary disease were more likely to use these drugs, whereas patients with cerebrovascular disease were less likely to use these drugs. In adjusted analyses, benzodiazepine or zolpidem use was associated with a 15% higher mortality rate. Chronic obstructive pulmonary disease significantly modified this association, suggesting that these patients were at higher risk. No association was found between benzodiazepine use and greater risk for hip fracture. We conclude that benzodiazepine or zolpidem use is common in incident dialysis patients and may be associated with greater mortality. Further studies are needed to elucidate the safety of these drugs in the dialysis population, which may lead to cautious and restrictive utilization of omega-receptor agonists in dialysis patients.