Kidney Res Clin Pract > Volume 39(1); 2020 > Article |
|
Authors’ contributions
Sukrit Kanchanasurakit, Aimusa Arsu, Wuttikorn Siriplabpla, and Surasak Saokaew contributed to the research idea and design. Sukrit Kanchanasurakit and Aimusa Arsu created the search strategy. Sukrit Kanchanasurakit and Aimusa Arsu screened titles, abstracts, and full texts. Sukrit Kanchanasurakit, Aimusa Arsu, and Surasak Saokaew contributed to data extraction and quality assessment. Sukrit Kanchanasurakit and Surasak Saokaew contributed to statistical analysis and interpretation of data. Sukrit Kanchanasurakit wrote the first draft of the manuscript. Wuttikorn Siriplabpla, Acharaporn Duangjai, and Surasak Saokaew edited the draft of the manuscript. All authors contributed to the critical revision of the manuscript for important intellectual content, approved and reviewed the final manuscript.
Characteristic | Author (year) | ||||
---|---|---|---|---|---|
|
|||||
Sandler et al (1989) [28] | Kantachuvesiri et al (1996) [26] | Agodoa et al (2008) [24] | de Vries et al (2010) [25] | Kelkar et al (2012) [27] | |
Setting | North Carolina medical lefts | Ramathibodi Hospital, Srinagarind Hospital, Maharat Nakhon Ratchasima Hospital | National Health and Nutrition Examination Survey | The UK General Practice Research Database (GPRD) | IMS Life Link Health Plans commercial |
Region | USA | Thailand | USA | UK | USA |
Study design | Case-control study | Case-control study | Cohort study | Cohort study | Case-control study |
Duration of study | 2 years | N/A | 3 years | 20 years | 12 years |
Sample size | 1,013 | 420 | 6,436 | 416 | 4,829 |
Characteristics of participants | Adult aged 30 to 79 years old with first diagnosed of CKD (SCr ≥ 130 μmol/L) | Adult (≥ 25 yr) with SCr 176.8 μmol/L or above and newly diagnosed as chronic tubulointerstitial nephritis | Healthy volunteers aged ≥ 20 yr with had no history of renal failure | Patients (≥ 18 yr) got a prescription for acetaminophen | Adult (≥ 18 yr) who had ≥ 1 incident of renal disease in the primary diagnosis field |
Comorbidity of participants | N/A | N/A | Diabetes mellitus | Cancer | Liver disease |
Hypertension | Heart failure | Heart disease | |||
Cardiovascular disease | Ischemic heart disease | Hypertension | |||
Cerebrovascular disease | Kidney infections | ||||
Depression | Substance abuse | ||||
Diabetes mellitus | Diabetes mellitus | ||||
Substance abuse | Metabolic variables | ||||
Osteoarthritis | Cancer | ||||
Autoimmune disease | |||||
Upper gastrointestinal disease | |||||
Interventions/exposure (no-use versus) | Daily users were defined as persons who had taken APAP for at least 360 consecutive days | Used APAP | Used APAP nearly every day for as long as a month | First prescription, patients who received their first | Acute APAP exposure |
Weekly users as those who had taken APAP at least once a week for 1 year | cumulative dose were 0.1-99.9 g, 100-999.9 g, and ≥ 1,000 g | APAP prescription ≥ 12 months after the start data collection |
MDD: 30 days pre-index - ≤ 4 g - > 4 g |
||
Long gap, patients with ≥ 6 months between a preceding prescription for APAP | Chronic APAP exposure | ||||
Cumulative dosage in the pre-index year - ≤ 1 kg - > 1 kg |
|||||
Type of renal impairment | CKD | CKD | CKD | AKI | AKI or CKD |
Renal impairment ascertainment | ICD-9-CM codes and SCr level | newly diagnosed as chronic tubulointerstitial nephritis or SCr level | reduced eGFR and ACR | assessed with OXMIS and Read codes | ICD-9-CM codes |
Effect size (95% CI) | Weekly = 1.21 (0.77-1.89) | 0.1-99.9 g = 0.50 (0.30-1.00) | 1.03 (0.60-1.70) | First prescription = 1.31 (1.03-1.68) | (a)c = 1.64 (1.40-1.92) |
Daily = 3.21 (1.05-9.80) | 100-999.9 g = 1.30 (0.70-2.70) | Long gap = 1.21 (1.02-1.43) | (b)c = 2.01 (1.49-2.70) | ||
≥ 1,000 g = 6.20 (1.70-22.5) | (c)c = 1.13 (1.01-1.26) | ||||
(d)c = 0.97 (0.45-2.12) | |||||
Confounders adjusted | Age, race, sex, income, proximity to the study hospitals | N/A | Age, race, sex, education level, specific habitual analgesic use, comorbidities | Age, sex, body mass index, smoking history or alcohol use, year report, number of visit, hospital admission, previous medication use | Previous medication use, comorbidities |
Age of exposure group (year) | 63b | 53.9 (±3.1)a | N/A | 62.5b | 60.8 (± 17.8)a |
Female (%) | N/A | 54.76 | 54.0 | 64.0 | 47.4 |
Down and black score | 15 | 14 | 19 | 19 | 14 |
ACR, albumin-creatinine ratio; AKI, Acute kidney injury; APAP, acetaminophen; CKD, Chronic kidney disease; eGFR, estimated glomerular filtration rate; ICD-9-CM, International Classification of Diseases, 9th Revision, Clinical Modification; MDD, maximum daily dosage; N/A, not available; SCr, serum creatinine; UK, United Kingdom; USA, United States of America.
Characteristic | All studies | Cohort studies | Case-control studies | ||||||
---|---|---|---|---|---|---|---|---|---|
|
|
|
|||||||
Adjusted OR (95% CI) | Heterogeneity | Adjusted OR (95% CI) | Heterogeneity | Adjusted OR (95% CI) | Heterogeneity | ||||
|
|
|
|||||||
I2 value (%) | P value | I2 value (%) | P value | I2 value (%) | P value | ||||
Models | |||||||||
Fixed-effects model | 1.29 (1.20-1.38) | 74.2 | < 0.001 | 1.23 (1.07-1.44) | 0.0 | 0.692 | 1.31 (1.20-1.42) | 80.6 | < 0.001 |
Random-effects model | 1.31 (1.10-1.57) | 74.2 | < 0.001 | 1.23 (1.07-1.40) | 0.0 | 0.692 | 1.37 (1.05-1.80) | 80.6 | < 0.001 |
Omitted Kantachuvesiri et al [26] (a) and Kelkar et al [27] (b) in the analysis of case-control studya | |||||||||
Before omitted | 1.31 (1.10-1.57) | 74.2 | < 0.001 | 1.23 (1.07-1.40) | 0.0 | 0.692 | 1.37 (1.05-1.80) | 80.6 | < 0.001 |
After omitted | 1.31 (1.12-1.54) | 63.0 | 0.004 | 1.23 (1.07-1.40) | 0.0 | 0.692 | 1.42 (1.08-1.87) | 74.2 | < 0.001 |
Omitted Kantachuvesiri et al [26] (a)-(b) and (c) in the analysis of case-control studyb | |||||||||
Before omitted | 1.31 (1.10-1.57) | 74.2 | < 0.001 | 1.23 (1.07-1.40) | 0.0 | 0.692 | 1.37 (1.05-1.80) | 80.6 | < 0.001 |
After omitted | 1.36 (1.15-1.60) | 70.8 | 0.001 | 1.23 (1.07-1.40) | 0.0 | 0.692 | 1.46 (1.12-1.91) | 80.6 | < 0.001 |
Dose of acetaminophen | |||||||||
Usual therapeutic dosec | 1.23 (1.03-1.46) | 70.4 | 0.001 | 1.23 (1.07-1.40) | 0.0 | 0.692 | 1.22 (0.91-1.64) | 80.9 | < 0.001 |
Toxic dosed | 1.98 (0.94-4.17) | 67.9 | 0.044 | N/A | N/A | N/A | 1.98 (0.94-4.17) | 67.9 | 0.044 |
Duration use of acetaminophen | |||||||||
Short-term usee | 1.21 (0.95-1.55) | 78.0 | 0.001 | 1.24 (1.08-1.43) | 0.0 | 0.601 | 1.06 (0.57-1.95) | 86.6 | 0.001 |
Long-term usef | 1.17 (0.95-1.45) | 17.0 | 0.306 | 1.03 (0.61-1.73) | N/A | N/A | 1.32 (0.87-1.99) | 42.3 | 0.177 |
Type of toxic dose | |||||||||
Acute toxic ingestiong | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A |
Chronic toxic ingestionh | 1.98 (0.94-4.17) | 67.9 | 0.044 | N/A | N/A | N/A | 1.98 (0.94-4.17) | 67.9 | 0.044 |
Type of renal impairmenti | |||||||||
Acute kidney injury | 1.24 (1.08-1.43) | 0.0 | 0.601 | 1.24 (1.08-1.43) | 0.0 | 0.601 | N/A | N/A | N/A |
Chronic kidney disease | 1.32 (0.78-2.23) | 71.4 | 0.004 | 1.03 (0.61-1.73) | N/A | N/A | 1.47 (0.74-2.92) | 76.9 | 0.002 |
Acute kidney injury or Chronic kidney disease | 1.45 (1.06-1.97) | 87.0 | < 0.001 | N/A | N/A | N/A | 1.45 (1.06-1.97) | 87.0 | < 0.001 |
Exposure to other potentially nephrotoxic drugs preceding the index date | |||||||||
Yes | 1.37 (1.14-1.65) | 79.2 | < 0.001 | 1.24 (1.08-1.43) | 0.0 | 0.601 | 1.45 (1.06-1.97) | 87.0 | < 0.001 |
No | 1.32 (0.78-2.23) | 71.4 | 0.004 | 1.03 (0.61-1.73) | N/A | N/A | 1.47 (0.74-2.92) | 76.9 | 0.002 |
Comorbidity | |||||||||
Cardiovascular disease | |||||||||
Yes | 1.34 (1.13-1.60) | 75.7 | < 0.001 | 1.23 (1.07-1.40) | 0.0 | 0.692 | 1.45 (1.06-1.97) | 87.0 | < 0.001 |
No | 1.47 (0.74-2.92) | 76.9 | 0.002 | N/A | N/A | N/A | 1.47 (0.74-2.92) | 76.9 | 0.002 |
Hypertension | |||||||||
Yes | 1.34 (1.13-1.60) | 75.7 | < 0.001 | 1.23 (1.07-1.40) | 0.0 | 0.692 | 1.45 (1.06-1.97) | 87.0 | < 0.001 |
No | 1.47 (0.74-2.92) | 76.9 | 0.002 | N/A | N/A | N/A | 1.47 (0.74-2.92) | 76.9 | 0.002 |
Diabetes mellitus | |||||||||
Yes | 1.34 (1.13-1.60) | 75.7 | < 0.001 | 1.23 (1.07-1.40) | 0.0 | 0.692 | 1.45 (1.06-1.97) | 87.0 | < 0.001 |
No | 1.47 (0.74-2.92) | 76.9 | 0.002 | N/A | N/A | N/A | 1.47 (0.74-2.92) | 76.9 | 0.002 |
Quality of the study (ROBIN-I) | |||||||||
Low | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A |
Moderate | 1.24 (1.09-1.41) | 0.0 | 0.469 | 1.23 (1.07-1.40) | 0.0 | 0.692 | 1.71 (0.69-4.29) | 60.4 | 0.112 |
Serious | 1.34 (0.98-1.82) | 84.4 | < 0.001 | N/A | N/A | N/A | 1.34 (0.98-1.82) | 84.4 | < 0.001 |
Quality of the study (NOS) | |||||||||
Star > 7 | 1.23 (1.07-1.40) | 0.0 | 0.692 | 1.23 (1.07-1.40) | 0.0 | 0.692 | N/A | N/A | N/A |
Star ≤ 7 | 1.37 (1.05-1.80) | 80.6 | < 0.001 | N/A | N/A | N/A | 1.37 (1.05-1.80) | 80.6 | < 0.001 |
Quality of the study (Downs and Black score) | |||||||||
Score > 20 | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A |
Score ≤ 20 | 1.31 (1.10-1.57) | 74.2 | < 0.001 | 1.23 (1.07-1.40) | 0.0 | 0.692 | 1.37 (1.05-1.80) | 80.6 | < 0.001 |
APAP, acetaminophen; CI, confidence interval; N/A, not available; NOS, Newcastle-Ottawa Scale. aSelected from influence plot (Supplementary Fig. 3); bStudy unadjusted results; cDose of APAP ≤ 4 g in 24 hours; dIncluding acute toxic dose and chronic toxic dose; eUse usual therapeutic doses continuously ≤ 30 days or use < 15 dose/month or lifetime cumulative dose 0.1-99.9 g; fUse usual therapeutic doses continuously > 30 days or use ≥ 15 dose/month or lifetime cumulative dose 100-999.9 g; gSingle ingestion of > 4 g in period of < 1 hour; hIngestion > 4 g in 24 hours for a long time 3-4 days or lifetime cumulative dose > 1,000 g; iFollowing definition by Kidney Disease Improving Global Outcomes (KDIGO) [12,13].