ArticleDeutsches Arzteblatt international2022
Metamizole-Associated Risks in Decompensated Hepatic Cirrhosis.
Article in Deutsches Arzteblatt international, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- To use or not to use: Safety of selected painkillers in patients with chronic liver diseases.Clinical and experimental hepatology · 2025Review
- Efficacy of metamizole to prevent kidney injury after renal-ischaemic reperfusion injury in Wistar rats.Annals of medicine and surgery (2012) · 2024Article
- Effects of renin-angiotensin inhibitors on renal function and the clinical course in patients with decompensated cirrhosis.Scientific reports · 2023Article
- Clinical Guideline on Perioperative Management of Patients with Advanced Chronic Liver Disease.Life (Basel, Switzerland) · 2023Review
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Authors and funding
14 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundBecause of the increased risk of acute renal failure (ARF), the use of cyclooxygenase (COX) inhibitors is not recommended in patients with decompensated hepatic cirrhosis. Metamizole is not a classic COX inhibitor, but there are insufficient data to support its safe use. In this study, we investigate the effect of metamizole on the risk of ARF in these patients.
methodsMetamizole use, ARF incidence, and patient mortality were examined in a large, retrospective, exploratory cohort and validated with data from a prospective registry.
results523 patients were evaluated in the exploratory cohort. Metamizole use at baseline was documented in 110 cases (21%) and was independently associated with the development of ARF, severe (grade 3) ARF, and lower survival without liver transplantation at follow-up on day 28 (HR: 2.2, p < 0.001; HR: 2.8, p < 0.001; and HR: 2.6, p < 0.001, respectively). Interestingly, the risk of ARF depended on the dose of metamizole administered (HR: 1.038, p < 0.001). Compared to patients who were treated with opioids, the rate of ARF was higher in the metamizole group (49% vs. 79%, p = 0.014). An increased risk of ARF with metamizole use was also demonstrated in the independent validation cohort (p < 0.001).
conclusionMetamizole therapy, especially at high doses, should only be used with a high level of caution in patients with decompensated cirrhosis.
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