Evidence map›Paper›PMID 30815270›Full record

ArticleCanadian journal of kidney health and disease2019

Outcomes Following Macrolide Use in Kidney Transplant Recipients.

Rachel Jeong, Robert R Quinn, Krista L Lentine, Anita Lloyd, Pietro Ravani, Brenda Hemmelgarn, Branko Braam, Amit X Garg, Kevin Wen, Anita Wong-Chan and 2 more

Registry-linked trialOpen access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Canadian journal of kidney health and disease, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07098078 (Domperidone Dose and the Risk of Serious Adverse Events in Older Adults With Advanced Chronic Kidney Disease), which is not on this map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
1.0field-weighted citation impact, top 25% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07098078 completednot on this map

Domperidone Dose and the Risk of Serious Adverse Events in Older Adults With Advanced Chronic Kidney Disease: A Population-Based Cohort Study Research Protocol

TypeobservationalSponsorLondon Health Sciences Centre Research Institute OR Lawson Research Institute of St. Joseph'sRan2008 to 2024Enrolled15,000ConditionsChronic Kidney Disease (CKD)ArmsDomperidone (drug)
3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 16 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 4 institutions in 2 countries.

Rachel JeongDepartment of Medicine, Division of Nephrology, University of Alberta, Edmonton, AB, Canada.
Robert R QuinnDepartments of Community Health Sciences and Medicine, University of Calgary, Calgary, AB, Canada.
Krista L LentineCenter for Abdominal Transplantation, Saint Louis University School of Medicine, St. Louis, MO, USA.
Anita LloydDepartment of Medicine, Division of Nephrology, University of Alberta, Edmonton, AB, Canada.
Pietro RavaniDepartment of Medicine, Division of Nephrology, University of Calgary, Calgary, AB, Canada.ORCID https://orcid.org/0000-0001-6973-8570
Brenda HemmelgarnDepartment of Medicine, Division of Nephrology, University of Calgary, Calgary, AB, Canada.
Branko BraamDepartment of Medicine, Division of Nephrology, University of Alberta, Edmonton, AB, Canada.
Amit X GargDepartment of Medicine, Division of Nephrology, Western University, London, ON, Canada.
Kevin WenDepartment of Medicine, Division of Nephrology, University of Alberta, Edmonton, AB, Canada.
Anita Wong-ChanDepartment of Medicine, Division of Nephrology, University of Alberta, Edmonton, AB, Canada.
Sita GourishankarDepartment of Medicine, Division of Nephrology, University of Alberta, Edmonton, AB, Canada.
Ngan N LamDepartment of Medicine, Division of Nephrology, University of Alberta, Edmonton, AB, Canada.
University of Alberta · CAUniversity of Calgary · CASaint Louis University · USWestern University · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCalcineurin inhibitors (CNI; cyclosporine, tacrolimus) are critical for kidney transplant immunosuppression, but have multiple potential drug interactions, such as with macrolide antibiotics. Macrolide antibiotics (clarithromycin, erythromycin, and azithromycin) are often used to treat atypical infections. Clarithromycin and erythromycin inhibit CNI metabolism and increase the risk of CNI nephrotoxicity, while azithromycin does not.

objectiveTo determine the frequency of CNI-macrolide co-prescriptions, the proportion who receive post-prescription monitoring, and the risk of adverse drug events in kidney transplant recipients.

designRetrospective cohort study.

settingWe used linked health care databases in Alberta, Canada. PATIENTS: We included 293 adult kidney transplant recipients from 2008-2015 who were co-prescribed a CNI and macrolide. MEASUREMENTS: The primary outcome was a composite of all-cause hospitalization, acute kidney injury (creatinine increase ≥0.3 mg/dL or 1.5 times baseline), or death within 30 days of the macrolide prescription.

methodsWe identified CNI-macrolide co-prescriptions and compared outcomes in those who received clarithromycin/erythromycin versus azithromycin. We used a linear mixed-effects model to examine the mean change in serum creatinine and estimated glomerular filtration rate (eGFR).

resultsOf the 293 recipients who were co-prescribed a CNI and a macrolide, 38% (n = 112) were prescribed clarithromycin/erythromycin while 62% (n = 181) were prescribed azithromycin. Compared with azithromycin users, clarithromycin/erythromycin users were less likely to have outpatient serum creatinine monitoring post-prescription (56% vs 69%, LIMITATIONS: We did not have CNI levels to correlate with the timing of CNI-macrolide co-prescriptions. We also did not have information regarding the indications for macrolide prescriptions.

conclusionClarithromycin and erythromycin were frequently co-prescribed in kidney transplant recipients on CNIs despite known drug interactions. Clarithromycin/erythromycin use was associated with a higher risk of hospitalization compared with azithromycin users. Safer prescribing practices in kidney transplant recipients are warranted.

Indexed as

adverse drug eventcalcineurin inhibitorkidney transplantmacrolide

Identifiers

PMID30815270
PMCPMC6385328
OpenAlexW2917564178

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.