Department of Pharmacy, Kaetsu Hospital, Niigata, Japan.
Department of Pharmacy, Tachikawa General Hospital, Niigata, Japan.
Br J Clin Pharmacol. 2024 Mar;90(3):900-904. doi: 10.1111/bcp.15974. Epub 2023 Dec 4.
Although diuretics play an important role in triple-whammy acute kidney injury (AKI), it is unclear whether the type of diuretic influences the risk of triple-whammy AKI. The aim of this study was to evaluate whether vasopressin receptor antagonists affect triple-whammy AKI. This cross-sectional study used disproportionality analysis of VigiBase data to assess the risk of AKI with various diuretics. Although multiple logistic regression analysis showed that aldosterone antagonists (odds ratio [OR] 2.19, 95% CI 2.01-2.37), loop diuretics (OR 4.40, 95% CI 4.07-4.76) and thiazide diuretics (OR 1.98, 95% CI 1.83-2.15) increased the risk of AKI in patients who received non-steroidal anti-inflammatory drugs (NSAIDs) and renin-angiotensin system inhibitors (RASi), vasopressin receptor antagonists did not increase the risk of AKI in those patients. Vasopressin receptor antagonists might not influence the development of triple-whammy AKI.
尽管利尿剂在三联急性肾损伤(AKI)中发挥着重要作用,但目前尚不清楚利尿剂的类型是否会影响三联 AKI 的风险。本研究旨在评估血管加压素受体拮抗剂是否会影响三联 AKI。本横断面研究使用 VigiBase 数据的比例失衡分析来评估各种利尿剂与 AKI 的风险。尽管多变量逻辑回归分析显示,醛固酮拮抗剂(比值比 [OR] 2.19,95%置信区间 [CI] 2.01-2.37)、袢利尿剂(OR 4.40,95%CI 4.07-4.76)和噻嗪类利尿剂(OR 1.98,95%CI 1.83-2.15)增加了接受非甾体抗炎药(NSAIDs)和肾素-血管紧张素系统抑制剂(RASi)的患者 AKI 的风险,但血管加压素受体拮抗剂并未增加这些患者 AKI 的风险。血管加压素受体拮抗剂可能不会影响三联 AKI 的发生。