Medication Use, Renin-Angiotensin System Inhibitors, and Acute Care Utilization After Hospitalization in Patients with Chronic Kidney Disease
Document Type
Article
Abstract
OBJECTIVES: The aims of this secondary analysis were to: (a) characterize medication use following hospital discharge for patients with chronic kidney disease (CKD), and (b) investigate relationships of medication use with the primary composite outcome of acute care utilization 90 days after hospitalization.
METHODS: The CKD-Medication Intervention Trial (CKD-MIT) enrolled acutely ill hospitalized patients with CKD stages 3-5 not dialyzed (CKD 3-5 ND). In this post hoc analysis, data for medication use were characterized, and the relationship of medication use with the primary outcome was evaluated using Cox proportional hazards models.
RESULTS: Participants were taking a mean of 12.6 (standard deviation=5.1) medications, including medications from a wide variety of medication classes. Nearly half of study participants were taking angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARB). ACE inhibitor/ARB use was associated with decreased risk of the primary outcome (hazard ratio=0.51; 95% confidence interval 0.28-0.95; p=0.03) after adjustment for baseline estimated glomerular filtration rate, age, sex, race, blood pressure, albuminuria, and potential nephrotoxin use.
CONCLUSIONS: A large number, variety, and complexity of medications were used by hospitalized patients with CKD 3-5 ND. ACE inhibitor or ARB use at hospital discharge was associated with a decreased risk of 90-day acute care utilization.
Digital Object Identifier (DOI)
Publication Info
Published in Journal of the Renin-Angiotensin-Aldosterone System : JRAAS, Volume 21, Issue 3, 2020.
APA Citation
Neumiller, J. J., Daratha, K. B., Alicic, R. Z., Short, R. A., Miller, H. M., Gregg, L., Gates, B. J., Corbett, C. F., McPherson, S. M., & Tuttle, K. R. (2020). Medication use, renin–angiotensin system inhibitors, and acute care utilization after hospitalization in patients with chronic kidney disease. Journal of the Renin-Angiotensin-Aldosterone System, 21(3), 147032032094513. https://doi.org/10.1177/1470320320945137
Rights
© The Author(s) 2020. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License https://creativecommons.org/licenses/by-nc/4.0/ which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages https://us.sagepub.com/en-us/nam/open-access-at-sage. https://creativecommons.org/licenses/by-nc/4.0/ which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages https://us.sagepub.com/en-us/nam/open-access-at-sage