Evidence map›Paper›PMID 37231800›Full record

ArticleAmerican journal of nephrology2023

Documented Adverse Drug Reactions and Discontinuation of Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers in Chronic Kidney Disease.

L Parker Gregg, Peter A Richardson, Michael A Herrera, Julia M Akeroyd, Shehrezade A Jafry, Glenn T Gobbel, Sheena Wydermyer, Jennifer Arney, Adriana Hung, Michael E Matheny and 2 more

Open access · greenAbstract read
In one paragraph

Article in American journal of nephrology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
2.3field-weighted citation impact, top 11% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 9 citations in OpenAlex.

  1. Article
  2. Article
  3. Tolerability of Antihypertensive Medications: The Influence of Age.High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension · 2024
    Article
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 5 institutions in 1 country.

L Parker GreggSelzman Institute for Kidney Health, Section of Nephrology, Baylor College of Medicine, Houston, Texas, USA.
Peter A RichardsonMichael E. DeBakey VA Medical Center Health Services Research & Development Center for Innovations in Quality, Effectiveness and Safety, Houston, Texas, USA.
Michael A HerreraMichael E. DeBakey VA Medical Center Health Services Research & Development Center for Innovations in Quality, Effectiveness and Safety, Houston, Texas, USA.
Julia M AkeroydMichael E. DeBakey VA Medical Center Health Services Research & Development Center for Innovations in Quality, Effectiveness and Safety, Houston, Texas, USA.
Shehrezade A JafryMichael E. DeBakey VA Medical Center Health Services Research & Development Center for Innovations in Quality, Effectiveness and Safety, Houston, Texas, USA.
Glenn T GobbelDepartment of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Sheena WydermyerDepartment of Medicine, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, USA.
Jennifer ArneyMichael E. DeBakey VA Medical Center Health Services Research & Development Center for Innovations in Quality, Effectiveness and Safety, Houston, Texas, USA.
Adriana HungDivision of Nephrology and Hypertension, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Michael E MathenyGeriatrics Research Education and clinical Care Service, Tennessee Valley Healthcare System VA, Nashville, Tennessee, USA.
Salim S ViraniMichael E. DeBakey VA Medical Center Health Services Research & Development Center for Innovations in Quality, Effectiveness and Safety, Houston, Texas, USA.
Sankar D NavaneethanSelzman Institute for Kidney Health, Section of Nephrology, Baylor College of Medicine, Houston, Texas, USA.
Michael E. DeBakey VA Medical Center · USVanderbilt University Medical Center · USBaylor College of Medicine · USUniversity of Houston - Clear Lake · USVA Tennessee Valley Healthcare System · US

Funding

MENTORED PATIENT-ORIENTED RESEARCH TOWARDS OPTIMIZING CARDIOVASCULAR OUTCOMES IN CHRONIC KIDNEY DISEASEK24HL161414 · NHLBI · BAYLOR COLLEGE OF MEDICINE · PI Sankar Dass Navaneethan · 2022 to 2026
$588k
Improving Analysis of Endogenous Multimodal Treatments for Use in Geriatrics Health Outcomes StudiesI01HX002237 · VA · VA BOSTON HEALTH CARE SYSTEM · PI GARRIDO, MELISSA M · 2018 to 2021
–
Optimizing Renin Angiotensin System Blocker Use among Veterans with Kidney DiseaseI01HX002917 · VA · MICHAEL E DEBAKEY VA MEDICAL CENTER · PI NAVANEETHAN, SANKAR DASS, VIRANI, SALIM S · 2020 to 2025
–
Association of diuretics with change in extracellular volume, natriuretic peptides, symptoms, and cardiovascular outcomes in CKDIK2CX002368 · VA · MICHAEL E DEBAKEY VA MEDICAL CENTER · PI Lucile Parker Gregg · 2022 to 2027
–
CSRD VA IK2 CX002368HSRD VA I01 HX002917HSRD VA SDR 02-237NHLBI NIH HHS K24 HL161414
6 · The paper itself

Abstract

introductionAngiotensin-converting enzyme inhibitors (ACEis) and angiotensin receptor blockers (ARBs) are frequently discontinued in patients with chronic kidney disease (CKD). Documented adverse drug reactions (ADRs) in medical records may provide insight into the reasons for treatment discontinuation.

methodsIn this retrospective cohort of US veterans from 2005 to 2019, we identified individuals with CKD and a current prescription for an ACEi or ARB (current user group) or a discontinued prescription within the preceding 5 years (discontinued group). Documented ADRs in structured datasets associated with an ACEi or ARB were categorized into 17 pre-specified groups. Logistic regression assessed associations of documented ADRs with treatment discontinuation.

resultsThere were 882,441 (73.0%) individuals in the current user group and 326,794 (27.0%) in the discontinued group. There were 26,434 documented ADRs, with at least one documented ADR in 7,520 (0.9%) current users and 9,569 (2.9%) of the discontinued group. ADR presence was associated with treatment discontinuation, aOR 4.16 (95% CI: 4.03, 4.29). The most common documented ADRs were cough (37.3%), angioedema (14.2%), and allergic reaction (10.4%). ADRs related to angioedema (aOR 3.81, 95% CI: 3.47, 4.17), hyperkalemia (aOR 2.03, 95% CI: 1.84, 2.24), peripheral edema (aOR 1.53, 95% CI: 1.33, 1.77), or acute kidney injury (aOR 1.32, 95% CI: 1.15, 1.51) were associated with treatment discontinuation.

conclusionADRs leading to drug discontinuation were infrequently documented. ADR types were differentially associated with treatment discontinuation. An understanding of which ADRs lead to treatment discontinuation provides an opportunity to address them at a healthcare system level.

Indexed as

AngioedemaDrug-Related Side Effects and Adverse ReactionsRenal Insufficiency, ChronicAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsHumansRetrospective StudiesAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsAdverse drug reactionAngiotensin-converting enzyme inhibitorsAngiotensin receptor blockersChronic kidney diseaseTreatment discontinuation

Identifiers

PMID37231800
PMCPMC10424561
OpenAlexW4378349621

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.