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Rise in acute kidney injury could be tied to certain BP medications
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An increase in acute kidney injuries could be related to increased prescribing of ACE inhibitors and angiotensin II receptor antagonists, according to a new report.
Researchers analyzed data on ACE inhibitors and AII receptor antagonists from an English prescribing database and data on acute kidney injury from an English hospital database, and matched prescribing data to numbers of hospital admissions for acute kidney injury at the general practice level.
ACE inhibitors and AII receptor antagonists are the second-most commonly prescribed medications in UK clinical practice, according to a press release.
Data were aggregated to four 1-year periods, starting in April 2007 and ending in March 2011. A mixed-effect Poisson regression model was used.
From the first year of the study to the last, admission rates for acute kidney injury increased 51.6%, from 0.38 per 1,000 patients to 0.57 per 1,000 patients, and annual prescribing rates for ACE inhibitors and AII receptor antagonists increased 15.8%, from 0.202 Age, Sex and Temporary Resident Originated Prescribing Units (ASTRO-PUs) to 0.234 ASTRO-PUs.
The average admission rate for acute kidney injury was 44% higher in the final year of the study than in the first year (P<.001). According to the results of the Poisson regression model, there was strong evidence that increases in practice-level prescribing of ACE inhibitors and AII receptor antagonists was correlated with increases in admission rates for acute kidney injury (P<.001).
An increase in prescribing of ACE inhibitors and AII receptor antagonists for a typical practice corresponded to an increase in admissions of approximately 5.1% (rate ratio=1.051 for a 0.03 per ASTRO-PU increase in annual prescribing rate; 95% CI, 1.047-1.055).
Using the regression model, the researchers predicted that 1,638 admissions for acute kidney injury would have been avoided had prescriptions for ACE inhibitors and AII receptor antagonists remained at the same rate as the first year of the study, equivalent to 14.8% of the total increase in admissions for acute kidney injury.
A limitation of the findings is that they do not include patient-level data, such as patient characteristics and prescription indications, the researchers wrote.
Disclosure: The researchers report no relevant financial disclosures.
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