ArticlePloS one2022
Time until onset of acute kidney injury by combination therapy with "Triple Whammy" drugs obtained from Japanese Adverse Drug Event Report database.
Article in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 17 citations in OpenAlex.
- Mineralocorticoid Receptor Antagonists in Chronic Kidney Disease: Clinical Evidence, Pharmacology, and Drug-Drug Interactions for Personalized Management of Hyperkalemia.International journal of molecular sciences · 2026Review
- Drug-specific risks of acute kidney injury associated with triple whammy therapy: a nationwide self-controlled case series study in Japan.Journal of pharmaceutical health care and sciences · 2026Article
- NSAID-Induced acute kidney injury risk in patients on renin-angiotensin system inhibitors and diuretics: nationwide cohort study.Journal of pharmaceutical health care and sciences · 2025Article
- Renal safety of Long-Term Non-steroidal Anti-inflammatory drugs use in patients with ankylosing spondylitis.Scientific reports · 2025Article
- Chronic kidney disease risk assessment: Findings from backward-looking study using annual health check-up data in Japan.Diabetes, obesity & metabolism · 2025Article
- Development and validation of a predictive model for acute kidney injury in patients with ureterolithiasis.Renal failure · 2024Article
- A pharmacovigilance study on clinical factors of active vitamin DScientific reports · 2024Article
- Evaluation of Triple Whammy Prescriptions After the Implementation of a Drug Safety Algorithm.Drugs - real world outcomes · 2024Article
- Application of multimodal ultrasonography to predicting the acute kidney injury risk of patients with sepsis: artificial intelligence approach.PeerJ. Computer science · 2024Article
- Characteristics, Risk Factors, and Outcomes in Acute Kidney Injury Patients: A Retrospective Cross-Sectional Study, Palestine.TheScientificWorldJournal · 2024Article
- Hospitalisations Related to the Combination of ACE Inhibitors and/or Angiotensin Receptor Blockers with Diuretics and NSAIDs: A Post Hoc Analysis on the Risks Associated with Triple Whammy.Healthcare (Basel, Switzerland) · 2023Article
- Detection of potential drug-drug interactions for risk of acute kidney injury: a population-based case-control study using interpretable machine-learning models.Frontiers in pharmacology · 2023Article
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Acute kidney injury (AKI) associated with "Triple Whammy" drug therapy consisting of renin-angiotensin system inhibitors, diuretics, and nonsteroidal anti-inflammatory drugs (NSAIDs) has been reported. There have been no reports investigating "Triple Whammy" drug therapy and the time to AKI onset using adverse drug events report databases. The aim of this study was to determine the relationship between the time to AKI onset and treatment with "Triple Whammy" drug therapy. We analyzed AKI cases registered in the Japanese Adverse Drug Event Report database. The data were analyzed using the Kaplan-Meier approach, generalized Wilcoxon tests, and Weibull distribution. AKI was reported in 18,415 cases, of which 7,466 cases used Triple Whammy drugs. All combinations of Triple Whammy drugs were associated with significantly higher odds ratios for reporting AKI. In Weibull analysis, AKI onset was early for most combination patterns of Triple Whammy drugs. The Kaplan-Meier approach showed that the treatment duration to AKI onset was much shorter in cases using NSAIDs; median onsets, 8 days for triple combination, 7 days for NSAIDs added to renin-angiotensin system inhibitors, 9 days for NSAIDs added to diuretics, 6 days for diuretics added to NSAIDs, and 9 days for NSAIDs alone. AKI associated with Triple Whammy drugs is likely to occur in the early stages of treatment, especially with concomitant NSAIDs. Patients should be monitored for the occurrence of AKI within the first 2 weeks.
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