Association between patient characteristics and serum creatinine increase ≥30% and follow-up monitoring within 2 weeks following initiation of ACE inhibitors or angiotensin receptor blockers
| OR (95% CIs) | ||||||
|---|---|---|---|---|---|---|
| Characteristics | Serum creatinine monitoring ≤2 weeks | Serum creatinine increase ≥30%* | Serum potassium increase ≥30%* | |||
| Age-adjusted and sex-adjusted | Fully adjusted† | Age-adjusted and sex-adjusted | Fully adjusted† | Age-adjusted and sex-adjusted | Fully adjusted† | |
| Female sex | 1.07 (1.04 to 1.10) | 1.07 (1.04 to 1.09) | 1.39 (1.26 to 1.53) | 1.63 (1.47 to 1.80) | 0.87 (0.66 to 1.16) | 0.94 (0.70 to 1.26) |
| Age (years) | ||||||
| <50 | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) |
| 50–59 | 0.98 (0.94 to 1.01) | 0.98 (0.95 to 1.02) | 0.88 (0.74 to 1.05) | 0.86 (0.72 to 1.03) | 1.29 (0.79 to 2.11) | 1.10 (0.67 to 1.81) |
| 60–69 | 1.05 (1.02 to 1.09) | 1.05 (1.01 to 1.09) | 1.03 (0.88 to 1.21) | 1.00 (0.85 to 1.19) | 1.35 (0.84 to 2.17) | 0.97 (0.60 to 1.58) |
| 70–79 | 1.18 (1.14 to 1.23) | 1.18 (1.13 to 1.23) | 1.49 (1.27 to 1.74) | 1.36 (1.15 to 1.61) | 1.65 (1.02 to 2.66) | 0.74 (0.43 to 1.26) |
| 80+ | 1.20 (1.14 to 1.25) | 1.17 (1.11 to 1.23) | 2.72 (2.32 to 3.20) | 2.02 (1.68 to 2.44) | 2.75 (1.67 to 4.53) | 0.73 (0.41 to 1.32) |
| CKD stage | ||||||
| No CKD (≥60) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) |
| Stage 3a (45–59) | 1.00 (0.96 to 1.04) | 1.00 (0.96 to 1.04) | 0.62 (0.53 to 0.73) | 0.60 (0.51 to 0.70) | 2.48 (1.66 to 3.71) | 2.06 (1.36 to 3.11) |
| Stage 3b (30–44) | 0.99 (0.93 to 1.06) | 1.01 (0.94 to 1.08) | 1.01 (0.82 to 1.24) | 0.88 (0.71 to 1.09) | 7.51 (4.75 to 11.9) | 5.10 (3.16 to 8.22) |
| Stage 4 (15–29) | 1.42 (1.21 to 1.67) | 1.41 (1.20 to 1.66) | 2.16 (1.52 to 3.05) | 1.72 (1.18 to 2.51) | 24.0 (13.5 to 42.6) | 11.4 (6.07 to 21.4) |
| Comorbidities* | ||||||
| Heart failure | 1.15 (1.09 to 1.23) | 1.16 (1.08 to 1.23) | 4.00 (3.49 to 4.58) | 2.93 (2.51 to 3.42) | 2.90 (1.90 to 4.42) | 2.22 (1.38 to 3.58) |
| MI | 0.80 (0.75 to 0.85) | 0.77 (0.72 to 0.82) | 2.33 (1.98 to 2.74) | 1.57 (1.32 to 1.87) | 2.12 (1.33 to 3.39) | 1.35 (0.80 to 2.25) |
| Hypertension | 1.00 (0.97 to 1.02) | 1.05 (1.00 to 1.11) | 0.62 (0.56 to 0.68) | 1.58 (1.36 to 1.84) | 0.60 (0.45 to 0.80) | 1.02 (0.63 to 1.65) |
| PAD | 1.09 (1.01 to 1.18) | 1.11 (1.02 to 1.20) | 2.10 (1.70 to 2.60) | 1.87 (1.50 to 2.33) | 2.14 (1.18 to 3.86) | 1.53 (0.82 to 2.88) |
| Arrhythmia | 1.09 (1.03 to 1.14) | 0.98 (0.95 to 1.01) | 2.37 (2.07 to 2.71) | 0.77 (0.69 to 0.86) | 1.41 (0.90 to 2.21) | 0.77 (0.56 to 1.05) |
| Diabetes mellitus | 0.93 (0.90 to 0.96) | 0.93 (0.90 to 0.96) | 1.09 (0.97 to 1.22) | 1.04 (0.92 to 1.18) | 0.97 (0.69 to 1.36) | 0.90 (0.63 to 1.29) |
| Baseline K>5 mmol/L | 1.04 (1.00 to 1.10) | 1.04 (0.99 to 1.09) | 1.04 (0.86 to 1.25) | 0.97 (0.80 to 1.17) | 8.22 (6.14 to 11.0) | 6.68 (4.94 to 9.02) |
*The increase was based on the difference between the most recent baseline measurements within 12 months before and first follow-up measurement within 2 months after drug initiation. All analyses were restricted to those with both baseline and follow-up measurements (n=105 859).
†Adjusted for sex, age, CKD, heart failure, MI, hypertension, PAD, arrhythmia, diabetes and calendar period of prescription start.
CKD, chronic kidney disease; K, potassium; MI, myocardial infarction; PAD, peripheral arterial disease.