{"id":34063,"date":"2013-01-10T20:01:03","date_gmt":"2013-01-11T01:01:03","guid":{"rendered":"http:\/\/blogs.nejm.org\/cardioexchange\/?post_type=news&#038;p=34063"},"modified":"2013-01-10T20:03:22","modified_gmt":"2013-01-11T01:03:22","slug":"acute-kidney-injury-associated-with-dual-antihypertensive-therapy-and-nsaids","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/cardioexchange\/2013\/01\/10\/acute-kidney-injury-associated-with-dual-antihypertensive-therapy-and-nsaids\/","title":{"rendered":"Acute Kidney Injury Associated With Dual Antihypertensive Therapy And NSAIDs"},"content":{"rendered":"<p>Adding a non-steroidal anti-inflammatory drug (NSAID) to dual antihypertensive therapy (a diuretic plus either an\u00a0ACE\u00a0inhibitor or an angiotensin receptor blocker) is associated with an increase in risk for kidney injury, according to\u00a0<a href=\"http:\/\/www.bmj.com\/content\/346\/bmj.e8525\">a large new retrospective study published in\u00a0<em>BMJ<\/em><\/a>.<\/p>\n<p>Analyzing data from nearly half a million people taking antihypertensive drugs, researchers found 2,215 cases of acute kidney injury after a mean followup of 5.9 years. People on dual therapy were not at increased risk for acute kidney injury. However, when NSAID use was added to dual therapy, there was a modest but significant increase in risk (rate ratio 1.31, CI 1.12- 1.53). The increase in risk was highest in the first month of treatment.<\/p>\n<p>The authors concluded that &#8220;increased vigilance may be warranted when&#8221; NSAIDs are used with dual antihypertensive therapy, especially in the early treatment period.<\/p>\n<p>In\u00a0<a href=\"http:\/\/www.bmj.com\/content\/346\/bmj.e8713\">an accompanying editorial<\/a>, Dorothea Nitsch and Laurie A Tomlinson write that the safety of dual therapy still remains to be demonstrated and that the\u00a0study likely &#8220;underestimates the true burden of drug associated acute kidney injury&#8221; in patients taking antihypertensive therapy and NSAIDs. Physicians should inform patients taking antihypertensive therapy about the possible risks of NSAID use and should\u00a0&#8220;be vigilant for signs of drug associated acute kidney injury in all patients.&#8221;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>NSAIDs seem to increase the risks for acute kidney injury when taken along with antihypertensive therapy consisting of a diuretic plus an ACE inhibitior or an ARB.<\/p>\n","protected":false},"author":196,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1,7],"tags":[512,718,647,674,1621,650],"class_list":["post-34063","post","type-post","status-publish","format-standard","hentry","category-general","category-prevention","tag-ace-inhibitors","tag-antihypertensive-therapy","tag-arbs","tag-diuretics","tag-kidney-injury","tag-nsaids"],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/34063","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/users\/196"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/comments?post=34063"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/34063\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/media?parent=34063"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/categories?post=34063"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/tags?post=34063"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}