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Association of Kidney-Related Safety Events with Incident Chronic Kidney Disease in Veterans

Helman SR, Department of Medicine, University of Maryland School of Medicine, USA, Stewart PM, Siddiqui T, Fink JC, Weiner S, Pharmaceutical Research Computing, University of Maryland School of Pharmacy, USA, Division of Endocrinology, Diabetes, and Nutrition, University of Maryland School of Medicine, USA, Department of Medicine, University of Maryland School of Medicine, USA, Department of Medicine, University of Maryland School of Medicine, USA
2021 Austin Journal of Nephrology and Hypertension  

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Objective: The impact of Nonsteroidal Anti-Inflammatory Drugs (NSAID) and iodine-based contrast exposures on developing Chronic Kidney Disease (CKD) is controversial. We examined the association of these exposures with the development of CKD in a Veteran population. Methods: A retrospective case-control study of 154,448 veterans from the Veterans Affairs (VA) Corporate Data Warehouse (CDW) database between 2005 and 2014 was conducted to assess the association between incident stage 3 CKD with
more » ... ute Kidney Injury (AKI), NSAID use, iodine-based contrast exposures, and comorbid conditions. Stepwise logistic regression was used to determine multivariable adjusted Odds Ratios (OR). Results: The mean age was 59 (SD±13), and the median eGFR was 84 (IQR: 73, 96). AKI was associated with increased odds of CKD (inpatient: OR=3.76, 95% CI: 3.44, 4.11; outpatient: OR=4.73, 95% CI: 4.09, 5.46) and demonstrated escalated odds with >1 episode (inpatient: OR=5.72, 95% CI: 4.71, 6.95; outpatient: OR=8.36, 95% CI: 6.32, 11.06). Months of NSAID prescriptions was associated with CKD, with ORs at >0-6 months, >6-12 months, and >12 months of 1.27 (95% CI: 1.23, 1.32), 1.54 (95% CI: 1.46, 1.63), and 1.69 (95% CI: 1.62, 1.77) respectively. Iodine-based contrast exposure was associated with increased odds of CKD, with ORs for 1-2 Computed Tomography (CT) scans, ≥3CT scans, and left heart catheterization of 1.29 (95% CI: 1.24, 1.35), 1.29 (95% CI: 1.20, 1.28), and 1.38 (95% CI: 1.17, 1.63) respectively. Conclusion: AKI events, NSAID use, and iodine-based contrast exposures are associated with increased odds for developing stage 3 CKD in veterans.
doi:10.26420/austinjnephrolhypertens.2021.1095 fatcat:sdhw57pdcbawxo3z6bdjtnfzra
Citation

Helman SR, Department of Medicine, University of Maryland School of Medicine, USA, Stewart PM, Siddiqui T, Fink JC, Weiner S, Pharmaceutical Research Computing, University of Maryland School of Pharmacy, USA, Division of Endocrinology, Diabetes, and Nutrition, University of Maryland School of Medicine, USA, Department of Medicine, University of Maryland School of Medicine, USA, Department of Medicine, University of Maryland School of Medicine, USA. "Association of Kidney-Related Safety Events with Incident Chronic Kidney Disease in Veterans." Austin Journal of Nephrology and Hypertension 8.2 (2021)