Kidney Week

Abstract: SA-PO911

Associations Between Risperidone Use and Kidney Function Decline in Patients With Schizophrenia

Session Information

• CKD: Clinical Trials and Pharmacoepidemiology
  November 05, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2202 CKD (Non-Dialysis): Clinical‚ Outcomes‚ and Trials

Authors

• Oshima, Megumi, Kanazawa Daigaku Daigakuin Iyaku Hokengaku Sogo Kenkyuka Iyaku Hoken Gakuiki Igakurui, Kanazawa, Ishikawa, Japan

Megumi Oshima,

• Toyama, Tadashi, Kanazawa Daigaku Daigakuin Iyaku Hokengaku Sogo Kenkyuka Iyaku Hoken Gakuiki Igakurui, Kanazawa, Ishikawa, Japan

Tadashi Toyama,

• Ogura, Hisayuki, Kanazawa Daigaku Daigakuin Iyaku Hokengaku Sogo Kenkyuka Iyaku Hoken Gakuiki Igakurui, Kanazawa, Ishikawa, Japan

Hisayuki Ogura,

• Nakagawa, Shiori, Kanazawa Daigaku Daigakuin Iyaku Hokengaku Sogo Kenkyuka Iyaku Hoken Gakuiki Igakurui, Kanazawa, Ishikawa, Japan

Shiori Nakagawa,

• Miyagawa, Taro, Kanazawa Daigaku Daigakuin Iyaku Hokengaku Sogo Kenkyuka Iyaku Hoken Gakuiki Igakurui, Kanazawa, Ishikawa, Japan

Taro Miyagawa,

• Kitajima, Shinji, Kanazawa Daigaku Daigakuin Iyaku Hokengaku Sogo Kenkyuka Iyaku Hoken Gakuiki Igakurui, Kanazawa, Ishikawa, Japan

Shinji Kitajima,

• Hara, Akinori, Kanazawa Daigaku Daigakuin Iyaku Hokengaku Sogo Kenkyuka Iyaku Hoken Gakuiki Igakurui, Kanazawa, Ishikawa, Japan

Akinori Hara,

• Iwata, Yasunori, Kanazawa Daigaku Daigakuin Iyaku Hokengaku Sogo Kenkyuka Iyaku Hoken Gakuiki Igakurui, Kanazawa, Ishikawa, Japan

Yasunori Iwata,

• Sakai, Norihiko, Kanazawa Daigaku Daigakuin Iyaku Hokengaku Sogo Kenkyuka Iyaku Hoken Gakuiki Igakurui, Kanazawa, Ishikawa, Japan

Norihiko Sakai,

• Shimizu, Miho, Kanazawa Daigaku Daigakuin Iyaku Hokengaku Sogo Kenkyuka Iyaku Hoken Gakuiki Igakurui, Kanazawa, Ishikawa, Japan

Miho Shimizu,

• Wada, Takashi, Kanazawa Daigaku Daigakuin Iyaku Hokengaku Sogo Kenkyuka Iyaku Hoken Gakuiki Igakurui, Kanazawa, Ishikawa, Japan

Takashi Wada,

Background

We have previously reported that the gut microbiota produces D-amino acids, and some acids have protective effects against acute kidney injury in mice. Risperidone is used as an atypical antipsychotic agent for schizophrenia and also known to inhibit the activity of D-amino acid oxidase. We thus hypothesized that risperidone may prevent kidney disease progression by enhancing the effects of D-amino acids and assessed the associations of risperidone use with kidney function decline in patients with schizophrenia.

Methods

This is a retrospective case-control study which included patients who were diagnosed with schizophrenia and had more than two measurements of serum creatinine at Kanazawa University Hospital between April 2010 and March 2020. Among them, 212 patients used risperidone for 30 days or more (risperidone group), while 1479 patients had no record of risperidone use (control group). The study outcome was a 40% decline in eGFR. Cox regression model was used to estimate the risk of kidney function decline.

Results

The mean(±SD) age was 55±19 years, 759 (45%) were men, and mean eGFR was 88±35 ml/min/1.73 m² at baseline. Both groups had similar baseline characteristics except for age: the risperidone group was younger than the control group (52 vs 56 years, p=0.006). During a mean follow-up of 1.6 years, 267 patients (16%) had a 40% eGFR decline. The incidence rate of a 40% eGFR decline was lower in the risperidone group than the control group (60 vs 104 per 1000 person-years). Compared with control, risperidone use was associated with a reduced risk of a 40% eGFR decline (HR 0.54, 95% CI 0.34 to 0.85, p=0.008). Similar association was observed after adjustment for baseline age, sex, and eGFR (0.54, 0.33 to 0.87, p=0.01).

Conclusion

Risperidone use was associated with a reduced risk of kidney function decline in patients with schizophrenia.