Acute kidney injury and morbi-mortality associated with "triple whammy" combination : Systematic review and meta-analysis
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)

Date:	2025
Abstract:	Aims: "Triple whammy" (TW) refers to the concomitant use of diuretics, renin-angiotensin-aldosterone system inhibitors (RAASI) and non-steroidal anti-inflammatory drugs (NSAIDs). The aim of this article is to analyse the association between TW exposure and acute kidney injury (AKI), among other morbi-mortality outcomes. Methods: We included studies published up to August 2023 in the Cochrane Library, Medline or EMBASE, among others. The risk of AKI within 12 months after TW vs. not exposed to TW was the main outcome. Results: We included five case-control studies, involving 410 130 participants. The risk of AKI was significantly higher among those exposed to TW vs. not exposed (odds ratio [OR] 2. 01, 95% confidence interval [CI] 1. 30-3. 10; four studies; I: 90%; low certainty of evidence). Three studies provided data on all-cause mortality, not showing a significantly higher risk with TW exposure (very low certainty of evidence). Conclusion: The available evidence reveals that TW may lead to a significantly higher risk of AKI and related hospitalizations, with no detrimental effect on mortality.
Note:	Altres ajuts: acords transformatius de la UAB
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Language:	Anglès
Document:	Article de revisió ; recerca ; Versió publicada
Subject:	Acute kidney injury ; Drug safety ; Nephrotoxicity ; Systematic review
Published in:	British Journal of Clinical Pharmacology, 2025 , ISSN 1365-2125

DOI: 10.1002/bcp.70263
PMID: 40876867

11 p, 1.6 MB

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