Maxime Desgrouas1, Thierry Boulain2. 1. Service de Médecine Intensive Réanimation, Centre Hospitalier Régional d'Orléans, 14 avenue de l'hôpital, 45100, Orléans, France. 2. Service de Médecine Intensive Réanimation, Centre Hospitalier Régional d'Orléans, 14 avenue de l'hôpital, 45100, Orléans, France. thierry.boulain@chr-orleans.fr.
Abstract
BACKGROUND: Mortality with rhabdomyolysis-associated acute kidney injury can be as high as 80%. Experimental data from mouse models of rhabdomyolysis showed that paracetamol reduces the expected increase in serum creatinine level. We aimed to assess the association between paracetamol use and the need for starting renal replacement therapy (RRT). METHODS: We conducted a propensity score-matched cohort study in Orléans Hospital, France (a 1136-bed, public, university-affiliated and teaching hospital). All patients with serum creatine phosphokinase (CK) level > 5000 IU/L between January 1st, 2008 and December 31st, 2017 were included. A propensity score was calculated for each included patient by using multivariable logistic regression and all available baseline characteristics. The main outcome was the incidence of RRT initiation from day 1 to day 28 in the propensity score-matched cohort between patients exposed and unexposed to paracetamol. RESULTS: Over the study period, 1065 patients with at least one CK level measurement > 5000 IU/L were included; 40 (3.8%) had at least one RRT session. Among the 343 matched pairs, 10 (2.9%) exposed and 24 (7.0%) unexposed patients underwent RRT before day 28 (P = 0.021). Primary time-to-event analysis showed that exposure to paracetamol was significantly associated with reduced absolute risk of RRT: absolute risk difference = - 3.18% (95% CI - 5.23 to - 1.20, P = 0.001). All secondary analyses showed a significantly reduced absolute risk of RRT in patients exposed to paracetamol. CONCLUSION: Our study showed a significant association between paracetamol exposure and reduced incidence of RRT among patients with rhabdomyolysis.
BACKGROUND:Mortality with rhabdomyolysis-associated acute kidney injury can be as high as 80%. Experimental data from mouse models of rhabdomyolysis showed that paracetamol reduces the expected increase in serum creatinine level. We aimed to assess the association between paracetamol use and the need for starting renal replacement therapy (RRT). METHODS: We conducted a propensity score-matched cohort study in Orléans Hospital, France (a 1136-bed, public, university-affiliated and teaching hospital). All patients with serum creatine phosphokinase (CK) level > 5000 IU/L between January 1st, 2008 and December 31st, 2017 were included. A propensity score was calculated for each included patient by using multivariable logistic regression and all available baseline characteristics. The main outcome was the incidence of RRT initiation from day 1 to day 28 in the propensity score-matched cohort between patients exposed and unexposed to paracetamol. RESULTS: Over the study period, 1065 patients with at least one CK level measurement > 5000 IU/L were included; 40 (3.8%) had at least one RRT session. Among the 343 matched pairs, 10 (2.9%) exposed and 24 (7.0%) unexposed patients underwent RRT before day 28 (P = 0.021). Primary time-to-event analysis showed that exposure to paracetamol was significantly associated with reduced absolute risk of RRT: absolute risk difference = - 3.18% (95% CI - 5.23 to - 1.20, P = 0.001). All secondary analyses showed a significantly reduced absolute risk of RRT in patients exposed to paracetamol. CONCLUSION: Our study showed a significant association between paracetamol exposure and reduced incidence of RRT among patients with rhabdomyolysis.
Authors: Olivier Boutaud; Kevin P Moore; Brandon J Reeder; David Harry; Alexander J Howie; Shuhe Wang; Clare K Carney; Tina S Masterson; Taneem Amin; David W Wright; Michael T Wilson; John A Oates; L Jackson Roberts Journal: Proc Natl Acad Sci U S A Date: 2010-02-01 Impact factor: 11.205
Authors: Esmael El-Abdellati; Michiel Eyselbergs; Halil Sirimsi; Viviane Van Hoof; Kristien Wouters; Walter Verbrugghe; Philippe G Jorens Journal: Ann Intensive Care Date: 2013-03-14 Impact factor: 6.925
Authors: Daniel J Cooper; Matthew J Grigg; Katherine Plewes; Giri S Rajahram; Kim A Piera; Timothy William; Jayaram Menon; Glenn Koleth; Michael D Edstein; Geoffrey W Birrell; Thanaporn Wattanakul; Joel Tarning; Aatish Patel; Tsin Wen Yeo; Arjen M Dondorp; Nicholas M Anstey; Bridget E Barber Journal: Clin Infect Dis Date: 2022-10-12 Impact factor: 20.999
Authors: Anthony Batte; Zachary Berrens; Kristin Murphy; Ivan Mufumba; Maithri L Sarangam; Michael T Hawkes; Andrea L Conroy Journal: Int J Nephrol Renovasc Dis Date: 2021-07-08