Opioid use and poisoning in hospitalized patients with chronic kidney disease.

IF 2.7 4区 医学 Q2 UROLOGY & NEPHROLOGY
Journal of Nephrology Pub Date : 2025-03-01 Epub Date: 2024-12-01 DOI:10.1007/s40620-024-02159-4
Nadim Zaidan, Youssef Jalloul, David S Goldfarb, Hiba Azar, Suzanne El-Sayegh
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引用次数: 0

Abstract

Background: Identifying factors associated with uncomplicated and complicated opioid use is essential, especially with regard to safety concerns in impaired kidney function. Literature about opioid prescription and their potential complications in patients with different stages of chronic kidney disease (CKD) is scarce. This study describes opioid use and poisoning in hospitalized CKD patients.

Methods: The National Inpatient Database (NIS) was queried from 2016 to 2020 to identify which patients with known CKD stages were admitted with diagnoses of uncomplicated and complicated opioid use, and opioid poisoning. Patients with end-stage kidney disease receiving any form of renal replacement therapy were excluded. CKD1 served as a reference, and demographic and socio-economic characteristics were accounted for. Logistic regressions were performed to evaluate the relationship between CKD stages and each condition.

Results: The final cohort included 2,917,404 (14,587,017 weighted) CKD patients, of whom 1.763 ± 0.023% and 1.177 ± 0.016% had uncomplicated and complicated opioid use, respectively. Odds of uncomplicated use were lower with more advanced CKD stages. We observed an increase of complicated use with milder forms of CKD. No differences in odds of complicated opioid use were found when CKD4-5 patients were compared to CKD1. After adjustment, opioid use was found to be the main predictor of poisoning in hospitalized CKD patients.

Conclusion: Prescribers appear to be more cautious in patients with advanced CKD, with lower odds of being on opioid analgesics in this group. Most CKD patients had higher odds of complicated use, and poisoning was essentially driven by complicated opioid use rather than CKD stage.

慢性肾病住院患者阿片类药物使用与中毒
背景:确定与简单和复杂阿片类药物使用相关的因素是必要的,特别是考虑到肾功能受损的安全性问题。关于阿片类药物处方及其在不同阶段慢性肾脏疾病(CKD)患者中的潜在并发症的文献很少。本研究描述了住院CKD患者阿片类药物的使用和中毒。方法:查询2016年至2020年国家住院患者数据库(NIS),以确定诊断为无并发症和复杂阿片类药物使用以及阿片类药物中毒的已知CKD分期患者。接受任何形式肾脏替代治疗的终末期肾病患者被排除在外。CKD1作为参考,并考虑到人口和社会经济特征。采用Logistic回归来评估CKD分期与每种情况之间的关系。结果:最终队列包括2,917,404例(14,587,017例加权)CKD患者,其中无阿片类药物使用分别为1.763±0.023%和1.177±0.016%。CKD越晚期,单纯使用的几率越低。我们观察到轻度CKD的复杂使用增加。与CKD1患者相比,CKD4-5患者的阿片类药物复杂使用的几率没有差异。调整后,发现阿片类药物使用是住院CKD患者中毒的主要预测因素。结论:对于晚期CKD患者,开处方者似乎更加谨慎,该组使用阿片类镇痛药的几率较低。大多数CKD患者有较高的复杂使用几率,中毒主要是由阿片类药物的复杂使用而不是CKD阶段引起的。
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
Journal of Nephrology
Journal of Nephrology 医学-泌尿学与肾脏学
CiteScore
5.60
自引率
5.90%
发文量
289
审稿时长
3-8 weeks
期刊介绍: Journal of Nephrology is a bimonthly journal that considers publication of peer reviewed original manuscripts dealing with both clinical and laboratory investigations of relevance to the broad fields of Nephrology, Dialysis and Transplantation. It is the Official Journal of the Italian Society of Nephrology (SIN).
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