Does Metamizole Cause Less Acute Kidney Injury than Non-Steroidal Anti-Inflammatory Drugs When Combined with Diuretics and Antihypertensives?
Calvo, Dulce Maria (Universitat Autònoma de Barcelona)
Saiz, Luis Carlos (Instituto de Investigación Sanitaria de Navarra)
Leache, Leire (Instituto de Investigación Sanitaria de Navarra)
Celaya Lecea, M Concepción (Instituto de Investigación Sanitaria de Navarra)
Gutiérrez-Valencia, Marta (Instituto de Investigación Sanitaria de Navarra)
Alonso, Alvaro (Universidad Emory (Estats Units d'Amèrica))
Erviti, Juan (Instituto de Investigación Sanitaria de Navarra)

Data:	2025
Resum:	The concurrent use of (a) diuretics, (b) renin-angiotensin-aldosterone system inhibitors (RAASIs), and (c) non-steroidal anti-inflammatory drugs (NSAIDs) or metamizole, known as the triple whammy (TW) combination, increases the risk of acute kidney injury (AKI). This study compared TWs including metamizole versus NSAIDs regarding hospitalisation for AKI, need for renal replacement therapy (RRT), and all-cause mortality during hospitalisation. Serum creatinine (sCr) and estimated glomerular filtration rate (eGFR) changes in the first year after TW initiation were also assessed. A nested case-control study was conducted within a cohort of adults receiving TW therapy (2009-2018). Logistic regression models analysed the associations between TW type and outcomes. Among 65,077 individuals (mean age 79. 7 years; 26. 3% male), TW including an NSAID was associated with a lower risk of AKI-related hospitalisation [adjusted odds ratio (aOR) 0. 81, 95%CI 0. 74-0. 87] and all-cause mortality (aOR 0. 64, 95%CI 0. 49-0. 82) compared to TW including metamizole. No significant differences were found in other variables. These findings suggest that TW including an NSAID may reduce the risk of AKI-related hospitalisation and mortality compared to TW including metamizole, although kidney function parameters remained unaffected. Further research is needed to confirm these results.
Nota:	This research was 50% co-funded by the Government of Navarre (Spain) and the European Regional Development Fund (ERDF) through the 2014\u20132020 ERDF Operational Programme of Navarre (Resolution 1021/2019, project No. 24).
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Lesión renal aguda ; Antihipertensivos ; Diuréticos ; Metamizol ; Agentes antiinflamatorios no esteroideos ; Seguridad ; Triple efecto
Publicat a:	Toxics, Vol. 13 Núm. 5 (may 2025) , p. 417, ISSN 2305-6304

DOI: 10.3390/toxics13050417
PMID: 40423496

13 p, 229.8 KB

El registre apareix a les col·leccions:
Articles > Articles de recerca
Articles > Articles publicats