Influence of vasopressin receptor antagonists on triple-whammy acute kidney injury: A VigiBase analysis

Br J Clin Pharmacol. 2024 Mar;90(3):900-904. doi: 10.1111/bcp.15974. Epub 2023 Dec 4.

Abstract

Although diuretics play an important role in triple-whammy acute kidney injury (AKI), it is unclear whether the type of diuretic influences the risk of triple-whammy AKI. The aim of this study was to evaluate whether vasopressin receptor antagonists affect triple-whammy AKI. This cross-sectional study used disproportionality analysis of VigiBase data to assess the risk of AKI with various diuretics. Although multiple logistic regression analysis showed that aldosterone antagonists (odds ratio [OR] 2.19, 95% CI 2.01-2.37), loop diuretics (OR 4.40, 95% CI 4.07-4.76) and thiazide diuretics (OR 1.98, 95% CI 1.83-2.15) increased the risk of AKI in patients who received non-steroidal anti-inflammatory drugs (NSAIDs) and renin-angiotensin system inhibitors (RASi), vasopressin receptor antagonists did not increase the risk of AKI in those patients. Vasopressin receptor antagonists might not influence the development of triple-whammy AKI.

Keywords: acute kidney injury; diuretics; non-steroidal anti-inflammatory drugs; renin-angiotensin system inhibitors; vasopressin receptor antagonists.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Kidney Injury* / chemically induced
  • Acute Kidney Injury* / epidemiology
  • Angiotensin Receptor Antagonists / adverse effects
  • Angiotensin-Converting Enzyme Inhibitors* / adverse effects
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects
  • Antidiuretic Hormone Receptor Antagonists / adverse effects
  • Cross-Sectional Studies
  • Diuretics / adverse effects
  • Humans

Substances

  • Angiotensin-Converting Enzyme Inhibitors
  • Antidiuretic Hormone Receptor Antagonists
  • Angiotensin Receptor Antagonists
  • Anti-Inflammatory Agents, Non-Steroidal
  • Diuretics