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Abstract: PO2280

Prescribed Medications for Nausea and Vomiting Symptoms and Incident CKD in US Veterans

Session Information

Category: CKD (Non-Dialysis)

  • 2101 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Kalantar, Diana S., VA Long Beach Healthcare System, Long Beach, California, United States
  • Wenziger, Cachet, VA Long Beach Healthcare System, Long Beach, California, United States
  • Potukuchi, Praveen Kumar, The University of Tennessee Health Science Center, Memphis, Tennessee, United States
  • Dashputre, Ankur A., The University of Tennessee Health Science Center, Memphis, Tennessee, United States
  • Sumida, Keiichi, The University of Tennessee Health Science Center, Memphis, Tennessee, United States
  • Kovesdy, Csaba P., VA Memphis Medical Center, Memphis, Tennessee, United States
  • Kalantar-Zadeh, Kamyar, VA Long Beach Healthcare System, Long Beach, California, United States
  • Streja, Elani, VA Long Beach Healthcare System, Long Beach, California, United States
Background

Unpleasant upper gastrointestinal symptoms including nausea and vomiting and prescribed medication for their management may have important clinical implications as prelude to incident of chronic kidney disease (CKD), a hypothesis we sought to examine in US Veterans without reduced kidney function.

Methods

In 2,524,842 US Veterans with normal baseline eGFR (≥60 ml/min/1.73m2) and available data on albuminuria in 2004-2006, we examined the association of de novo prescription of anti-emetic medications during the baseline period with incident CKD over 14 years. Associations were examined in hazard models adjusted for demographics, major comorbidities, baseline eGFR, and albuminuria category.

Results

We identified 14,813 Veterans who were incident new anti-emetic users. Patients were a mean 61±14 years old, 7% female, 16% Black, and 5% Hispanic. Anti-emetic medication users were more likely to be female, White, smokers, with higher frequencies of comorbidities such as chronic obstructive pulmonary disease, cancer, and diabetes. Anti-emetic medication users had an almost 2-fold higher incident rate of CKD compared to non-users [4.7 (95% CI 4.6-4.9) per 100 patient years vs. 2.4/100PY (2.4-2.4), a faster time to incident CKD (Figure 1), and a 73% higher multivariable adjusted hazard (HR: 1.73, 95%CI: 1.69, 1.78) of incident CKD.

Conclusion

De novo prescription of anti-emetic medications in Veterans without reduced kidney function is associated with 73% higher likelihood of incident CKD independent of comorbidities and other potential confounders. Higher incident CKD likelihood may be due to prescribed anti-emetic medications or this relationship may represent the association of the unpleasant upper gastrointestinal symptoms with CKD risk, which warrants additional studies.

Funding

  • Veterans Affairs Support