Taking Sleeping Pills and the Risk of Chronic Kidney Disease: A Nationwide Population-Based Retrospective Cohort Study

Liao, Chen-Yi; Chung, Chi‐Hsiang; Lu, Kuo‐Cheng; Cheng, Cheng‐Yi; Yang, Sung-Sen; Chien, Wu-Chien; Wu, Chia-Chao

doi:10.3389/fphar.2020.524113

Cited by 2 publications

(1 citation statement)

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“…Diazepam is a common sedative-hypnotic drug in clinical settings, and the ADRs described in SPC include drowsiness, fatigue, muscle weakness, urinary retention, or incontinence. A nationwide population-based retrospective cohort study showed that diazepam had a significant correlation with increased chronic kidney disease risk in the population aged >18 years old (adjusted hazard ratio (HR) = 1.627, 95 CI%:1.527-1.736) (Liao et al, 2020). One of the possible mechanisms is that propylene glycol is contained in parenteral formulations of diazepam, which may cause AKI and proximal tubule injury (Cawley, 2001).…”

Section: Potential New Signalsmentioning

confidence: 99%

Detection of pediatric drug-induced kidney injury signals using a hospital electronic medical record database

Nie

Zhao

et al. 2022

Front. Pharmacol.

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Background: Drug-induced kidney injury (DIKI) is one of the most common complications in clinical practice. Detection signals through post-marketing approaches are of great value in preventing DIKI in pediatric patients. This study aimed to propose a quantitative algorithm to detect DIKI signals in children using an electronic health record (EHR) database.Methods: In this study, 12 years of medical data collected from a constructed data warehouse were analyzed, which contained 575,965 records of inpatients from 1 January 2009 to 31 December 2020. Eligible participants included inpatients aged 28 days to 18 years old. A two-stage procedure was adopted to detect DIKI signals: 1) stage 1: the suspected drugs potentially associated with DIKI were screened by calculating the crude incidence of DIKI events; and 2) stage 2: the associations between suspected drugs and DIKI were identified in the propensity score-matched retrospective cohorts. Unconditional logistic regression was used to analyze the difference in the incidence of DIKI events and to estimate the odds ratio (OR) and 95% confidence interval (CI). Potentially new signals were distinguished from already known associations concerning DIKI by manually reviewing the published literature and drug instructions.Results: Nine suspected drugs were initially screened from a total of 652 drugs. Six drugs, including diazepam (OR = 1.61, 95%CI: 1.43–1.80), omeprazole (OR = 1.35, 95%CI: 1.17–1.54), ondansetron (OR = 1.49, 95%CI: 1.36–1.63), methotrexate (OR = 1.36, 95%CI: 1.25–1.47), creatine phosphate sodium (OR = 1.13, 95%CI: 1.05–1.22), and cytarabine (OR = 1.17, 95%CI: 1.06–1.28), were demonstrated to be associated with DIKI as positive signals. The remaining three drugs, including vitamin K1 (OR = 1.06, 95%CI: 0.89–1.27), cefamandole (OR = 1.07, 95%CI: 0.94–1.21), and ibuprofen (OR = 1.01, 95%CI: 0.94–1.09), were found not to be associated with DIKI. Of these, creatine phosphate sodium was considered to be a possible new DIKI signal as it had not been reported in both adults and children previously. Moreover, three other drugs, namely, diazepam, omeprazole, and ondansetron, were shown to be new potential signals in pediatrics.Conclusion: A two-step quantitative procedure to actively explore DIKI signals using real-world data (RWD) was developed. Our findings highlight the potential of EHRs to complement traditional spontaneous reporting systems (SRS) for drug safety signal detection in a pediatric setting.

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Section: Potential New Signalsmentioning

confidence: 99%