Two HTN Meds Plus NSAIDs Ups Acute Kidney Injury Risk

Risk up with use of diuretic and ACE inhibitor or angiotensin receptor blocker, plus NSAID

WEDNESDAY, Jan. 9 (HealthDay News) -- Use of triple therapy comprising diuretics and angiotensin converting enzyme inhibitors, or angiotensin receptor blockers, together with nonsteroidal anti-inflammatory drugs (NSAIDs) is associated with an increased risk of acute kidney injury, particularly in the first 30 days of treatment, according to a study published online Jan. 8 in BMJ.

Francesco Lapi, Ph.D., from the Jewish General Hospital in Montreal, and colleagues conducted a nested case-control analysis to examine whether a double therapy combination (diuretics, angiotensin converting enzyme inhibitors, or angiotensin receptor blockers plus NSAIDs) or triple therapy (diuretics with angiotensin converting enzyme inhibitors or angiotensin receptor blockers, plus NSAIDs) correlated with the risk of acute kidney injury in a cohort of 487,372 antihypertensive drug users.

During a mean follow-up of 5.9 years, the researchers identified 2,215 cases of acute kidney injury. Overall, there was no increased risk of acute kidney injury with current use of a double therapy combination. However, there was a significantly increased risk of acute kidney injury with current use of a triple therapy combination (rate ratio, 1.31). The highest risk was seen in the first 30 days of use (rate ratio, 1.82).

"Given that NSAIDs are widely used (40 to 60 percent as lifetime prevalence in the general population) and that a greater incidence rate of acute kidney injury was estimated among antihypertensive drugs users than in the general population, increased vigilance may be warranted when diuretics and angiotensin converting enzyme inhibitors or angiotensin receptor blockers are used concurrently with NSAIDs," the authors write.

Two authors disclosed financial ties to the pharmaceutical industry.

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