速尿对住院患者有肾毒性吗?

IF 0.2 Q4 UROLOGY & NEPHROLOGY

Journal of Renal Injury Prevention Pub Date : 2023-04-10 DOI:10.34172/jrip.2023.32164

Kyaw Kyaw Hoe, Swane Rowe-Gardener, Thant Hnin Saint Hoe

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引用次数: 0

摘要

引言：急性肾脏疾病在某些情况下是可以预防的。长期和/或高剂量速尿可能导致急性肾损伤。目的：我们旨在了解暴露于速尿的住院患者中AKI的风险。患者和方法：这是一项对2019年至2021年间入院期间接受速尿治疗的住院患者的回顾性队列研究。速尿暴露分为低剂量（≤40mg/d）或高剂量（>40mg/d，短期使用（≤72小时）或长期使用（>72小时）。急性肾损伤的风险以95%置信区间（CI）的比值比计算。P值为40mg/d，121名患者（61.4%）服用速尿>7天（比值比[OR]:5.46，95%CI:3.17-9.39，P≤0.001；比值比:7.72，95%CI:4.4-13.52，P≤0.001]），87名（44.1%）接受≤40mg/d速尿治疗的患者AKI发生率较低（ORs:0.25，95%CI:0.13-0.48，P≤0.001），在接受速尿治疗<7天的患者中，只有21名（10.6%）出现急性肾损伤（ORs:0.08，95%CI:0.04-0.14，P≤001）100例（31.8%）接受速尿>40mg治疗>72小时的患者中，96例（30.6%）出现AKI（ORs:26.8，95%CI:9.53-75.63，P≤0.001）。结论：在住院患者中，暴露于大剂量速尿或长期使用速尿与AKI有关。当高剂量速尿给药时间超过72小时时，风险更大。潜在糖尿病、高血压、心力衰竭和慢性肾脏疾病的存在也与速尿诱导的医院获得性急性肾损伤有关。

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Is furosemide a nephrotoxic for hospitalized patients?

Introduction: Acute kidney disease (AKI) is preventable in certain situations. Long-term and/or high dose furosemide may lead to acute kidney injury. Objectives: We aimed to find the risk of AKI among hospitalised patients who were exposed to furosemide. Patients and Methods: This is a retrospective cohort study of hospitalised patients who received furosemide therapy during the admission between 2019 and 2021. Exposure to furosemide was grouped into low dose (≤ 40 mg/d) or high dose (>40 mg/d) and short-term use (≤ 72 hours) or long-term use (>72 hours). Risk of acute kidney injury was calculated as odds ratios with a 95% confidence interval (CI). A P value <0.05 was considered statistically significant. Results: Of 314 patients who received furosemide intravenously or orally, 197 patients (62.7%) had acute kidney injury. Of 197 patients with acute kidney injury, 110 patients (55.9%) received the dosage of >40 mg/d and 121 patients (61.4%) were on furosemide for >7 days (odds ratios [ORs]: 5.46, 95% CI: 3.17 to 9.39, P≤0.001 and ORs: 7.72, 95% CI: 4.4 to 13.52, P≤0.001). In comparison, the 87 (44.1%) patients who received ≤40 mg/d of furosemide had a lower incidence of AKI (ORs: 0.25, 95% CI: 0.13 to 0.48, P≤0.001) and only 21 of the patients (10.6%) who received furosemide for < 7 days were found to have acute kidney injury (ORs: 0.08, 95% CI: 0.04 to 0.14, P≤0.001). The combined effect of high dose and long-term furosemide therapy is more consequential as we found that 100 (31.8%) patients who received furosemide >40 mg for >72 hours, 96 patients (30.6%) developed AKI (ORs: 26.8, 95% CI: 9.53 to 75.63, P≤0.001). Conclusion: Among hospitalised patients, exposure to high dose furosemide or prolonged use of furosemide is associated with AKI. The risk is more when high dose furosemide is administered for longer than 72 hours. Presence of underlying diabetes, hypertension, cardiac failure and chronic kidney disease, are also associated with furosemide -induced hospital-acquired acute kidney injury.

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来源期刊

Journal of Renal Injury Prevention UROLOGY & NEPHROLOGY-

CiteScore

1.60

自引率

0.00%

发文量

期刊介绍： The Journal of Renal Injury Prevention (JRIP) is a quarterly peer-reviewed international journal devoted to the promotion of early diagnosis and prevention of renal diseases. It publishes in March, June, September and December of each year. It has pursued this aim through publishing editorials, original research articles, reviews, mini-reviews, commentaries, letters to the editor, hypothesis, case reports, epidemiology and prevention, news and views and renal biopsy teaching point. In this journal, particular emphasis is given to research, both experimental and clinical, aimed at protection/prevention of renal failure and modalities in the treatment of diabetic nephropathy. A further aim of this journal is to emphasize and strengthen the link between renal pathologists/nephropathologists and nephrologists. In addition, JRIP welcomes basic biomedical as well as pharmaceutical scientific research applied to clinical nephrology. Futuristic conceptual hypothesis that integrate various fields of acute kidney injury and renal tubular cell protection are encouraged to be submitted.