Risk of Hospital-Acquired Acute Kidney Injury among Adult Opioid Analgesic Users: A Multicenter Real-World Data Analysis
Introduction: Comprehensive data on the risk of hospital-acquired (HA) acute kidney injury (AKI) among adult users of opioid analgesics are lacking. This study aimed to systematically compare the risk of HA-AKI among the users of various opioid analgesics. Methods: This multicenter, retrospective r...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Karger Publishers
2023-08-01
|
| Series: | Kidney Diseases |
| Online Access: | https://beta.karger.com/Article/FullText/533556 |
| _version_ | 1797690719660408832 |
|---|---|
| author | Mingjing Pi Sheng Nie Licong Su Yanqin Li Yue Cao Peiyan Gao Yuxin Lin yan zha Yongjun Shi Hua Li Jiajun Zhao Yaozhong Kong Guisen Li Ying Hu Huafeng Liu Qijun Wan Chunbo Chen Bicheng Liu Qiongqiong Yang Guobin Su Yilun Zhou Jianping Weng Gang Xu Hong Xu Ying Tang Mengchun Gong Fan Fan Hou Xin Xu |
| author_facet | Mingjing Pi Sheng Nie Licong Su Yanqin Li Yue Cao Peiyan Gao Yuxin Lin yan zha Yongjun Shi Hua Li Jiajun Zhao Yaozhong Kong Guisen Li Ying Hu Huafeng Liu Qijun Wan Chunbo Chen Bicheng Liu Qiongqiong Yang Guobin Su Yilun Zhou Jianping Weng Gang Xu Hong Xu Ying Tang Mengchun Gong Fan Fan Hou Xin Xu |
| author_sort | Mingjing Pi |
| collection | DOAJ |
| description | Introduction: Comprehensive data on the risk of hospital-acquired (HA) acute kidney injury (AKI) among adult users of opioid analgesics are lacking. This study aimed to systematically compare the risk of HA-AKI among the users of various opioid analgesics.
Methods: This multicenter, retrospective real-world study analyzed 255265 adult hospitalized patients who received at least one prescription of opioid analgesic during the first 30 days of hospitalization. Primary outcome was the time from the first opioid analgesic prescription to HA-AKI occurrence. 12 subtypes of opioid analgesics were analyzed, including 9 for treating moderate-to-severe pain and 3 for mild-to-moderate pain. We examined the association between the exposure to each subtype of opioid analgesic and the risk of HA-AKI using Cox proportional hazards models, using the most commonly used opioid analgesic as the reference group.
Results: As compared to dezocine, the most commonly used opioid analgesic treating moderate-to-severe pain, exposure to morphine, but not the other 7 types of opioid analgesics, was associated with a significantly increased risk of HA-AKI (adjusted hazard ratio 1.56, 95% confidence interval [CI] 1.40–1.78). The association was consistent in stratified analyses and in a propensity-matched cohort. There were no significant differences in the risk of HA-AKI among the opioid analgesics users with mild-to-moderate pain after adjusting for confounders.
Conclusion: The use of morphine was associated with an increased risk of HA-AKI in adult patients with moderate-to-severe pain. Opioid analgesics other than morphine should be chosen preferentially in adult patients with high risk of HA-AKI when treating moderate-to-severe pain. |
| first_indexed | 2024-03-12T02:03:11Z |
| format | Article |
| id | doaj.art-661ad8f167a646039c23c398361aa0a2 |
| institution | Directory Open Access Journal |
| issn | 2296-9357 |
| language | English |
| last_indexed | 2024-03-12T02:03:11Z |
| publishDate | 2023-08-01 |
| publisher | Karger Publishers |
| record_format | Article |
| series | Kidney Diseases |
| spelling | doaj.art-661ad8f167a646039c23c398361aa0a22023-09-07T07:56:39ZengKarger PublishersKidney Diseases2296-93572023-08-0110.1159/000533556533556Risk of Hospital-Acquired Acute Kidney Injury among Adult Opioid Analgesic Users: A Multicenter Real-World Data AnalysisMingjing PiSheng NieLicong SuYanqin LiYue CaoPeiyan GaoYuxin Linyan zhaYongjun ShiHua LiJiajun ZhaoYaozhong KongGuisen LiYing HuHuafeng LiuQijun WanChunbo ChenBicheng LiuQiongqiong YangGuobin SuYilun ZhouJianping WengGang XuHong XuYing TangMengchun GongFan Fan HouXin XuIntroduction: Comprehensive data on the risk of hospital-acquired (HA) acute kidney injury (AKI) among adult users of opioid analgesics are lacking. This study aimed to systematically compare the risk of HA-AKI among the users of various opioid analgesics. Methods: This multicenter, retrospective real-world study analyzed 255265 adult hospitalized patients who received at least one prescription of opioid analgesic during the first 30 days of hospitalization. Primary outcome was the time from the first opioid analgesic prescription to HA-AKI occurrence. 12 subtypes of opioid analgesics were analyzed, including 9 for treating moderate-to-severe pain and 3 for mild-to-moderate pain. We examined the association between the exposure to each subtype of opioid analgesic and the risk of HA-AKI using Cox proportional hazards models, using the most commonly used opioid analgesic as the reference group. Results: As compared to dezocine, the most commonly used opioid analgesic treating moderate-to-severe pain, exposure to morphine, but not the other 7 types of opioid analgesics, was associated with a significantly increased risk of HA-AKI (adjusted hazard ratio 1.56, 95% confidence interval [CI] 1.40–1.78). The association was consistent in stratified analyses and in a propensity-matched cohort. There were no significant differences in the risk of HA-AKI among the opioid analgesics users with mild-to-moderate pain after adjusting for confounders. Conclusion: The use of morphine was associated with an increased risk of HA-AKI in adult patients with moderate-to-severe pain. Opioid analgesics other than morphine should be chosen preferentially in adult patients with high risk of HA-AKI when treating moderate-to-severe pain.https://beta.karger.com/Article/FullText/533556 |
| spellingShingle | Mingjing Pi Sheng Nie Licong Su Yanqin Li Yue Cao Peiyan Gao Yuxin Lin yan zha Yongjun Shi Hua Li Jiajun Zhao Yaozhong Kong Guisen Li Ying Hu Huafeng Liu Qijun Wan Chunbo Chen Bicheng Liu Qiongqiong Yang Guobin Su Yilun Zhou Jianping Weng Gang Xu Hong Xu Ying Tang Mengchun Gong Fan Fan Hou Xin Xu Risk of Hospital-Acquired Acute Kidney Injury among Adult Opioid Analgesic Users: A Multicenter Real-World Data Analysis Kidney Diseases |
| title | Risk of Hospital-Acquired Acute Kidney Injury among Adult Opioid Analgesic Users: A Multicenter Real-World Data Analysis |
| title_full | Risk of Hospital-Acquired Acute Kidney Injury among Adult Opioid Analgesic Users: A Multicenter Real-World Data Analysis |
| title_fullStr | Risk of Hospital-Acquired Acute Kidney Injury among Adult Opioid Analgesic Users: A Multicenter Real-World Data Analysis |
| title_full_unstemmed | Risk of Hospital-Acquired Acute Kidney Injury among Adult Opioid Analgesic Users: A Multicenter Real-World Data Analysis |
| title_short | Risk of Hospital-Acquired Acute Kidney Injury among Adult Opioid Analgesic Users: A Multicenter Real-World Data Analysis |
| title_sort | risk of hospital acquired acute kidney injury among adult opioid analgesic users a multicenter real world data analysis |
| url | https://beta.karger.com/Article/FullText/533556 |
| work_keys_str_mv | AT mingjingpi riskofhospitalacquiredacutekidneyinjuryamongadultopioidanalgesicusersamulticenterrealworlddataanalysis AT shengnie riskofhospitalacquiredacutekidneyinjuryamongadultopioidanalgesicusersamulticenterrealworlddataanalysis AT licongsu riskofhospitalacquiredacutekidneyinjuryamongadultopioidanalgesicusersamulticenterrealworlddataanalysis AT yanqinli riskofhospitalacquiredacutekidneyinjuryamongadultopioidanalgesicusersamulticenterrealworlddataanalysis AT yuecao riskofhospitalacquiredacutekidneyinjuryamongadultopioidanalgesicusersamulticenterrealworlddataanalysis AT peiyangao riskofhospitalacquiredacutekidneyinjuryamongadultopioidanalgesicusersamulticenterrealworlddataanalysis AT yuxinlin riskofhospitalacquiredacutekidneyinjuryamongadultopioidanalgesicusersamulticenterrealworlddataanalysis AT yanzha riskofhospitalacquiredacutekidneyinjuryamongadultopioidanalgesicusersamulticenterrealworlddataanalysis AT yongjunshi riskofhospitalacquiredacutekidneyinjuryamongadultopioidanalgesicusersamulticenterrealworlddataanalysis AT huali riskofhospitalacquiredacutekidneyinjuryamongadultopioidanalgesicusersamulticenterrealworlddataanalysis AT jiajunzhao riskofhospitalacquiredacutekidneyinjuryamongadultopioidanalgesicusersamulticenterrealworlddataanalysis AT yaozhongkong riskofhospitalacquiredacutekidneyinjuryamongadultopioidanalgesicusersamulticenterrealworlddataanalysis AT guisenli riskofhospitalacquiredacutekidneyinjuryamongadultopioidanalgesicusersamulticenterrealworlddataanalysis AT yinghu riskofhospitalacquiredacutekidneyinjuryamongadultopioidanalgesicusersamulticenterrealworlddataanalysis AT huafengliu riskofhospitalacquiredacutekidneyinjuryamongadultopioidanalgesicusersamulticenterrealworlddataanalysis AT qijunwan riskofhospitalacquiredacutekidneyinjuryamongadultopioidanalgesicusersamulticenterrealworlddataanalysis AT chunbochen riskofhospitalacquiredacutekidneyinjuryamongadultopioidanalgesicusersamulticenterrealworlddataanalysis AT bichengliu riskofhospitalacquiredacutekidneyinjuryamongadultopioidanalgesicusersamulticenterrealworlddataanalysis AT qiongqiongyang riskofhospitalacquiredacutekidneyinjuryamongadultopioidanalgesicusersamulticenterrealworlddataanalysis AT guobinsu riskofhospitalacquiredacutekidneyinjuryamongadultopioidanalgesicusersamulticenterrealworlddataanalysis AT yilunzhou riskofhospitalacquiredacutekidneyinjuryamongadultopioidanalgesicusersamulticenterrealworlddataanalysis AT jianpingweng riskofhospitalacquiredacutekidneyinjuryamongadultopioidanalgesicusersamulticenterrealworlddataanalysis AT gangxu riskofhospitalacquiredacutekidneyinjuryamongadultopioidanalgesicusersamulticenterrealworlddataanalysis AT hongxu riskofhospitalacquiredacutekidneyinjuryamongadultopioidanalgesicusersamulticenterrealworlddataanalysis AT yingtang riskofhospitalacquiredacutekidneyinjuryamongadultopioidanalgesicusersamulticenterrealworlddataanalysis AT mengchungong riskofhospitalacquiredacutekidneyinjuryamongadultopioidanalgesicusersamulticenterrealworlddataanalysis AT fanfanhou riskofhospitalacquiredacutekidneyinjuryamongadultopioidanalgesicusersamulticenterrealworlddataanalysis AT xinxu riskofhospitalacquiredacutekidneyinjuryamongadultopioidanalgesicusersamulticenterrealworlddataanalysis |