The Association of Antiemetics Use With Incident Chronic Kidney Disease

Gastrointestinal symptoms can significantly impact patients' nutritional status. Effective management using antiemetics is crucial for maintaining adequate nutrition. However, the effect of antiemetics on long-term renal function remains unclear. This study aimed to examine the association of antiemetics with the incident chronic kidney disease (CKD) in patients with normal renal function.

In a historical cohort study involving 323,970 US Veterans with normal estimated glomerular filtration rate, we identified 13,154 Veterans initiating antiemetics. The Cox proportional hazards model adjusted for demographics, major comorbidities, and laboratory measurements was used to estimate the relationship between antiemetics and the incident CKD, defined as estimated glomerular filtration rate <60 mL/min/1.73 m² on two occasions, separated by ≥ 90 days. Propensity score (PS) matching and PS overlap weighting were also performed.

The mean age of nonusers and users of antiemetics was 64.1 ± 14.2 and 62.1 ± 12.9 years. Antiemetic users were more likely to be female, smokers, and had a higher prevalence of comorbidities. Antiemetic use was associated with an increased risk of incident CKD across various models: unmatched adjusted (hazard ratio [HR] 1.26; 95% confidence interval [CI] 1.22-1.31), PS matched (HR 1.22; 95% CI 1.17-1.28), and PS overlap weighting (HR 1.28; 95% CI 1.18-1.46).

Antiemetic use is associated with a higher risk of incident CKD in individuals without preexisting kidney disease. This association appears robust across different analytical models. While antiemetics are essential for managing gastrointestinal symptoms-potentially improving nutritional status-the results underscore the necessity for careful monitoring of renal function in patients prescribed antiemetics.