Sex Differences in Electrolyte Disturbances Among Diuretic Users According to Renal Function and Age.

IF 3.8 2区医学 Q1 PHARMACOLOGY & PHARMACY

Drug Safety Pub Date : 2025-06-25 DOI:10.1007/s40264-025-01564-3

Narumi Maida, Shingo Kondo, Naoko Hayashi, Hiroki Iwata, Noriko Kobayashi, Katsunori Yamaura

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Abstract

Introduction: Diuretics are widely used in Japan for the treatment of hypertension and heart failure. Electrolyte disturbance is a common adverse reaction to diuretics and may be life-threatening. Previous studies have shown that diuretic-induced electrolyte disturbance is more common in women. Electrolyte balance is regulated by the kidneys, and renal function tends to decline with advancing age.

Objective: The aim of this study was to identify patients at high risk of adverse reactions to diuretics, considering the effects of sex, renal function, and age on susceptibility to diuretic-induced electrolyte disturbance.

Methods: Claims data for 67,135 patients on diuretics in Japan were sourced from DeSC Healthcare, Inc. The data covered the period from April 2020 to March 2021.

Results: Analysis of patient numbers using the chi-squared test showed that hyperkalemia was more common in men than in women (326 vs. 271; p = 0.003) and that hypokalemia was more common in women than in men (413 vs. 285; p < 0.001). Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated for women considering age and renal function (estimated glomerular filtration rate [eGFR]). In elderly patients aged ≥ 75 years, the odds of developing hypokalemia in women compared to men were 1.47 (95% CI 1.13-1.91) for eGFR 60-30 mL/min/1.73 m² and 2.05 (95% CI 1.08-4.10) for eGFR < 30 mL/min/1.73 m².

Conclusion: Among women aged ≥ 75 years, those in lower eGFR groups (60-30 and < 30) had higher odds of hypokalemia compared to men. These data highlight the importance of monitoring for adverse reactions to diuretics, particularly hypokalemia, in elderly women with low eGFR.

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根据肾功能和年龄，利尿剂使用者电解质紊乱的性别差异。

导读：利尿剂在日本广泛用于高血压和心力衰竭的治疗。电解质紊乱是利尿剂常见的不良反应，可能危及生命。先前的研究表明，利尿剂引起的电解质紊乱在女性中更为常见。电解质平衡是由肾脏调节的，随着年龄的增长，肾功能有下降的趋势。目的：本研究的目的是识别利尿剂不良反应高危患者，考虑性别、肾功能和年龄对利尿剂引起的电解质紊乱的易感性的影响。方法：日本67,135例使用利尿剂患者的索赔数据来自DeSC Healthcare， Inc.。数据涵盖的时间为2020年4月至2021年3月。结果：使用卡方检验对患者数量的分析显示，高钾血症在男性中比在女性中更常见(326 vs 271；P = 0.003)，低钾血症在女性中比男性更常见(413 vs 285；P < 0.001)。考虑年龄和肾功能（估计肾小球滤过率[eGFR]）的女性计算95%置信区间（ci）的优势比（ORs）。在年龄≥75岁的老年患者中，eGFR 60-30 mL/min/1.73 m2的女性发生低钾血症的几率为1.47 (95% CI 1.13-1.91)， eGFR 2的女性发生低钾血症的几率为2.05 （95% CI 1.08-4.10）。结论：在年龄≥75岁的女性中，eGFR较低组（60-30岁和60-30岁）

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

Drug Safety 医学-毒理学

CiteScore

7.60

自引率

7.10%

发文量

112

审稿时长

6-12 weeks

期刊介绍： Drug Safety is the official journal of the International Society of Pharmacovigilance. The journal includes: Overviews of contentious or emerging issues. Comprehensive narrative reviews that provide an authoritative source of information on epidemiology, clinical features, prevention and management of adverse effects of individual drugs and drug classes. In-depth benefit-risk assessment of adverse effect and efficacy data for a drug in a defined therapeutic area. Systematic reviews (with or without meta-analyses) that collate empirical evidence to answer a specific research question, using explicit, systematic methods as outlined by the PRISMA statement. Original research articles reporting the results of well-designed studies in disciplines such as pharmacoepidemiology, pharmacovigilance, pharmacology and toxicology, and pharmacogenomics. Editorials and commentaries on topical issues. Additional digital features (including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations) can be published with articles; these are designed to increase the visibility, readership and educational value of the journal’s content. In addition, articles published in Drug Safety Drugs may be accompanied by plain language summaries to assist readers who have some knowledge of, but not in-depth expertise in, the area to understand important medical advances.