Enevoldsen Frederik Cosedis, Christiansen Christian Fynbo, Jensen Simon Kok
Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
Clin Epidemiol. 2023 Mar 7;15:275-287. doi: 10.2147/CLEP.S397415. eCollection 2023.
The occurrence of acute and chronic kidney diseases has been rising in the last decades. Although drug use is a common risk factor for impaired kidney function, changes in utilization of potential nephrotoxic drugs have received little attention.
To describe temporal trends in the utilization of potentially nephrotoxic drugs in Denmark between 1999 and 2021.
Specific drugs known or suspected to be nephrotoxic were identified in the literature. Data on the sold defined daily doses (DDDs) of potentially nephrotoxic drugs between 1999 and 2021 were retrieved using the Danish Register of Medical Product Statistics. Trends in sales of DDDs per 1000 inhabitants per day were tabulated and illustrated graphically.
From 1999 to 2021, the total sale of all selected drugs increased from 286 to 457 DDDs per 1000 inhabitants per day. The overall sale reached a preliminary peak in 2012 with 449 DDDs per 1000 inhabitants per day and remained relatively stable thereafter until reaching an all-time high in 2021 with 457 DDDs per 1000 inhabitants per day. Contributing with the majority in volume, sales of drugs inhibiting the renin-angiotensin-aldosterone system (RAAS) increased dramatically throughout the period. The same was observed for acetaminophen, methotrexate, tacrolimus, and iodinated contrast dye. In contrast, the sales of diuretics, acetylsalicylic acid, and ciclosporin decreased during the last decade of the study period.
From 1999-2021 considerable changes in sales of potentially nephrotoxic drugs were observed. In general, the sales increased, in volume predominated by RAAS inhibiting drugs. This increase in sales of potential nephrotoxins could contribute to an increasing occurrence of kidney diseases.
在过去几十年中，急慢性肾脏疾病的发病率一直在上升。尽管药物使用是肾功能受损的常见风险因素，但潜在肾毒性药物使用情况的变化却很少受到关注。
描述1999年至2021年丹麦潜在肾毒性药物的使用时间趋势。
在文献中确定已知或疑似具有肾毒性的特定药物。使用丹麦医疗产品统计登记册检索1999年至2021年期间潜在肾毒性药物的销售限定日剂量（DDD）数据。列出并以图形方式展示每1000居民每天DDD销售量的趋势。
从1999年到2021年，所有选定药物的总销售量从每1000居民每天286 DDD增加到457 DDD。总体销售量在2012年达到初步峰值，为每1000居民每天449 DDD，此后一直相对稳定，直到2021年达到历史最高水平，为每1000居民每天457 DDD。肾素 - 血管紧张素 - 醛固酮系统（RAAS）抑制剂的销售量在整个期间大幅增加，在数量上占主要部分。对乙酰氨基酚、甲氨蝶呤、他克莫司和碘化造影剂的销售情况也是如此。相比之下，在研究期的最后十年中，利尿剂、乙酰水杨酸和环孢素的销售量下降。
1999年至2021年期间，观察到潜在肾毒性药物的销售有相当大的变化。总体而言，销售量增加，在数量上以RAAS抑制剂为主。潜在肾毒素销售量的这种增加可能导致肾脏疾病发病率上升。
