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Identifying drug combinations associated with acute kidney injury using association rules method
Prasad S Nishtala1, Te-Yuan Chyou2
1Department of Pharmacy and Pharmacology, University of Bath, Bath, UK.
Pharmacoepidemiology and Drug Safety
|February 22, 2020
Summary
Older adults taking certain medications like trimethoprim and ondansetron face a higher risk of acute kidney injury (AKI). Association rule analysis identified these drug combinations contributing to AKI risk in seniors.
Area of Science:
- Gerontology
- Pharmacology
- Nephrology
Background:
- Older adults are disproportionately susceptible to acute kidney injury (AKI).
- Factors contributing to this risk include advanced age, multiple chronic conditions, and the use of multiple medications (polypharmacy).
Purpose of the Study:
- To employ association rule (AR) analysis to identify specific drug combinations associated with an increased risk of AKI in individuals aged 65 and older.
- To leverage big data analytics for uncovering novel drug-related risks for AKI in the elderly population.
Main Methods:
- A case-crossover study design was utilized, analyzing a nationwide sample of New Zealand adults aged 65+.
- Prescription data (2005-2015) and hospital discharge information were used to identify AKI cases and medication exposures.
- Association rule analysis was performed on medication classes including antimicrobials, diuretics, opioids, and NSAIDs to identify frequent drug combinations linked to AKI events.
Main Results:
- The study identified 55,747 individuals with incident AKI.
- Association rules revealed that antimicrobials, nonsteroidal anti-inflammatory drugs (NSAIDs), and opioids are linked to increased AKI risk.
- Specific drugs associated with AKI include trimethoprim (MOR=1.68), ondansetron (MOR=1.43), and a combination of codeine phosphate with metoclopramide (MOR=1.37).
Conclusions:
- Association rule analysis is a valuable method for identifying drug combinations contributing to AKI risk in older adults.
- The study confirmed known associations between certain drug classes and AKI, while also highlighting ondansetron as a potential risk factor requiring further investigation.
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