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Atypical antipsychotic drugs and the risk for acute kidney injury and other adverse outcomes in older adults: a population-based cohort study.
- Source :
-
Annals of internal medicine [Ann Intern Med] 2014 Aug 19; Vol. 161 (4), pp. 242-8. - Publication Year :
- 2014
-
Abstract
- Background: Several adverse outcomes attributed to atypical antipsychotic drugs, specifically quetiapine, risperidone, and olanzapine, are known to cause acute kidney injury (AKI). Such outcomes include hypotension, acute urinary retention, and the neuroleptic malignant syndrome or rhabdomyolysis.<br />Objective: To investigate the risk for AKI and other adverse outcomes associated with use of atypical antipsychotic drugs versus nonuse.<br />Design: Population-based cohort study.<br />Setting: Ontario, Canada, from 2003 to 2012.<br />Patients: Adults aged 65 years or older who received a new outpatient prescription for an oral atypical antipsychotic drug (n=97,777) matched 1:1 with those who did not receive such a prescription.<br />Measurements: The primary outcome was hospitalization with AKI (assessed by using a hospital diagnosis code and, in a subpopulation, serum creatinine levels) within 90 days of prescription for atypical antipsychotic drugs.<br />Results: Atypical antipsychotic drug use versus nonuse was associated with a higher risk for hospitalization with AKI (relative risk [RR], 1.73 [95% CI, 1.55 to 1.92]). This association was consistent when AKI was assessed in a subpopulation for which information on serum creatinine levels was available (5.46% vs. 3.34%; RR, 1.70 [CI, 1.22 to 2.38]; absolute risk increase, 2.12% [CI, 0.80% to 3.43%]). Drug use was also associated with hypotension (RR, 1.91 [CI, 1.60 to 2.28]), acute urinary retention (RR, 1.98 [CI, 1.63 to 2.40]), and all-cause mortality (RR, 2.39 [CI, 2.28 to 2.50]).<br />Limitation: Only older adults were included in the study.<br />Conclusion: Atypical antipsychotic drug use is associated with an increased risk for AKI and other adverse outcomes that may explain the observed association with AKI. The findings support current safety concerns about the use of these drugs in older adults.<br />Primary Funding Source: Academic Medical Organization of Southwestern Ontario.
- Subjects :
- Acute Kidney Injury diagnosis
Acute Kidney Injury epidemiology
Age Factors
Aged
Aged, 80 and over
Benzodiazepines adverse effects
Cause of Death
Creatinine blood
Dibenzothiazepines adverse effects
Female
Hospitalization statistics & numerical data
Humans
Hypotension chemically induced
Male
Olanzapine
Ontario epidemiology
Quetiapine Fumarate
Retrospective Studies
Risk Factors
Risperidone adverse effects
Urinary Retention chemically induced
Acute Kidney Injury chemically induced
Antipsychotic Agents adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 1539-3704
- Volume :
- 161
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Annals of internal medicine
- Publication Type :
- Academic Journal
- Accession number :
- 25133360
- Full Text :
- https://doi.org/10.7326/M13-2796