Risk of renal impairment in atypical antipsychotics: a systematic review and meta-analysis.

IF 2.4 3区医学 Q3 PHARMACOLOGY & PHARMACY

European Journal of Clinical Pharmacology Pub Date : 2024-10-01 Epub Date: 2024-06-25 DOI:10.1007/s00228-024-03714-5

Leong Tung Ong, Nicholas Ming Zher Chee, Audrey Joe Chii Loh

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引用次数: 0

Abstract

Purpose: Atypical antipsychotics are associated with several adverse effects including metabolic syndrome, weight gain, QTc interval prolongation, and extrapyramidal effects. This study aims to investigate the risk of renal impairment in patients receiving atypical antipsychotics.

Methods: A systematic literature search was conducted via PubMed and Ovid SP and Web of Science to retrieve studies reporting the risk of renal impairment in patients receiving atypical antipsychotic treatment. The pooled risk ratio (RR) of renal impairment and the subgroup analysis was calculated using the random-effects generic inverse variance method in Cochrane Review Manager.

Results: A total of 4 studies involving 514,710 patients (221, 873 patients on atypical antipsychotics/CKD and 292, 837 controls) were included in this meta-analysis. Patients on atypical antipsychotics exhibited an increased risk of renal impairment, with a pooled risk ratio of 1.34 (95%CI 1.23-1.47). Subgroup analysis demonstrated that atypical antipsychotic use was associated with an increased risk of both acute kidney injury (AKI) (RR 1.51, 95%CI 1.34-1.71) and chronic kidney disease (CKD) (RR: 1.23, 95%CI 1.12-1.35).

Conclusion: Patients receiving atypical antipsychotics have an increased risk of renal impairment. Quetiapine carries the highest risk of renal impairment encompassing both AKI and CKD.

Abstract Image

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非典型抗精神病药物的肾功能损害风险：系统回顾和荟萃分析。

目的：非典型抗精神病药物与多种不良反应相关，包括代谢综合征、体重增加、QTc间期延长和锥体外系效应。本研究旨在调查接受非典型抗精神病药物治疗的患者出现肾功能损害的风险：方法：通过PubMed、Ovid SP和Web of Science进行系统性文献检索，检索报道接受非典型抗精神病药物治疗的患者出现肾功能损害风险的研究。使用 Cochrane Review Manager 中的随机效应通用逆方差法计算了肾功能损害的汇总风险比 (RR) 和亚组分析：本荟萃分析共纳入了 4 项研究，涉及 514 710 名患者（221 873 名接受非典型抗精神病药物/CKD 治疗的患者和 292 837 名对照组患者）。服用非典型抗精神病药物的患者出现肾功能损害的风险增加，总风险比为 1.34（95%CI 1.23-1.47）。亚组分析表明，使用非典型抗精神病药物与急性肾损伤（AKI）（RR：1.51，95%CI：1.34-1.71）和慢性肾病（CKD）（RR：1.23，95%CI：1.12-1.35）的风险增加有关：结论：接受非典型抗精神病药物治疗的患者发生肾功能损害的风险增加。结论：接受非典型抗精神病药物治疗的患者肾功能损害的风险增加，其中喹硫平的肾功能损害风险最高，包括肾功能缺损和慢性肾脏病。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Clinical Pharmacology 医学-药学

CiteScore

5.40

自引率

3.40%

发文量

170

审稿时长

3-8 weeks

期刊介绍： The European Journal of Clinical Pharmacology publishes original papers on all aspects of clinical pharmacology and drug therapy in humans. Manuscripts are welcomed on the following topics: therapeutic trials, pharmacokinetics/pharmacodynamics, pharmacogenetics, drug metabolism, adverse drug reactions, drug interactions, all aspects of drug development, development relating to teaching in clinical pharmacology, pharmacoepidemiology, and matters relating to the rational prescribing and safe use of drugs. Methodological contributions relevant to these topics are also welcomed. Data from animal experiments are accepted only in the context of original data in man reported in the same paper. EJCP will only consider manuscripts describing the frequency of allelic variants in different populations if this information is linked to functional data or new interesting variants. Highly relevant differences in frequency with a major impact in drug therapy for the respective population may be submitted as a letter to the editor. Straightforward phase I pharmacokinetic or pharmacodynamic studies as parts of new drug development will only be considered for publication if the paper involves -a compound that is interesting and new in some basic or fundamental way, or -methods that are original in some basic sense, or -a highly unexpected outcome, or -conclusions that are scientifically novel in some basic or fundamental sense.