Incidence of hospital contacts with acute kidney injury after initiation of second-generation antipsychotics in older adults: a Danish population-based cohort study.

Purpose: To investigate the association between acute kidney injury (AKI) and use of second-generation antipsychotics (SGA) in older adults. Methods: In a population-based cohort study using Danish national registries, new users of SGAs (aged ≥ 65) were identified during 2005–2015. Each SGA user was...

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Published in:European Journal of Clinical Pharmacology Vol. 78; no. 8; pp. 1341 - 1350
Main Authors: Sharon, Reeha, Lange, Theis, Aakjær, Mia, Brøgger Kristiansen, Sarah, Baltzer Houlind, Morten, Andersen, Morten
Format: research tables/charts Journal Article
Published: Springer Nature Aug2022
Online Access:View this record in EBSCOhost
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      dt: Aug2022
      vid: 78
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00228-022-03339-6
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        atl: Incidence of hospital contacts with acute kidney injury after initiation of second-generation antipsychotics in older adults: a Danish population-based cohort study.
      aug:
        au:
          Sharon, Reeha
          Lange, Theis
          Aakjær, Mia
          Brøgger Kristiansen, Sarah
          Baltzer Houlind, Morten
          Andersen, Morten
        affil: Pharmacovigilance Research Center, Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
      sug:
        subj:
          Kidney Failure, Acute Risk Factors
          Antipsychotic Agents Therapeutic Use
          Antipsychotic Agents Adverse Effects
          Hospitals
          Kidney Failure, Acute Epidemiology
          Human
          Adult
          Prospective Studies
          Aged
          Aged, 80 and Over
          Matched Case Control
          Cox Proportional Hazards Model
          Descriptive Statistics
          Confidence Intervals
          Olanzapine Adverse Effects
          Quetiapine Adverse Effects
          Risperidone Adverse Effects
          Sensitivity and Specificity
          Adult: 19-44 years
          Aged: 65+ years
          Aged, 80 & over
      ab: Purpose: To investigate the association between acute kidney injury (AKI) and use of second-generation antipsychotics (SGA) in older adults. Methods: In a population-based cohort study using Danish national registries, new users of SGAs (aged ≥ 65) were identified during 2005–2015. Each SGA user was matched to 10 population controls on age, sex, and the SGA initiation date. The outcome was incident AKI within 90 days after the index date. Cox regression was used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs), adjusting for potential confounders. Results: In the study, 36,581 new SGA users and 365,810 controls were included. The 90-day incidence rate of AKI was 4.38 and 1.70 per 1000 person-years among SGA users and controls, respectively, corresponding to a crude HR of 2.57 (1.79–3.68). The fully adjusted HR (aHR) was 1.43 (0.89–2.27) for all SGAs. The risk differed among individual drugs with aHRs for olanzapine 3.50 (1.20–10.23), quetiapine 1.62 (0.81–3.26), and risperidone 0.68 (0.28–1.64). In sensitivity analyses, the aHR declined to 1.24 (0.95–1.61) at 1-year follow-up. Conclusions: Olanzapine use was associated with a significantly increased 90-day AKI risk. For quetiapine, the risk was elevated but not significant, and risperidone had no association. CIs were wide and confounder adjustment largely impacted the estimates. Main limitations included residual confounding and incomplete recording of AKI diagnoses.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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