Effect of Acetaminophen on the Prevention of Acute Kidney Injury in Patients With Sepsis

Asad E Patanwala, Ohoud Aljuhani, Hussain Bakhsh, Brian L Erstad

Research output: Contribution to journalArticle

Abstract

Background: Acute kidney injury (AKI) commonly occurs in patients with sepsis. Acetaminophen (APAP) has been shown to inhibit lipid peroxidation and, thus, may be renal protective in patients with sepsis. Objective: The objective of this study was to determine the effect of APAP on AKI in patients with sepsis. Methods: This was a retrospective cohort study conducted at 2 affiliated academic medical centers in the United States. Adult patients who were admitted to the intensive care unit with a diagnosis of severe sepsis were included. Patients were categorized based on whether APAP was received within the first 7 days of hospitalization (APAP or no APAP groups). The primary outcome measure was occurrence or increase in AKI stage from admission. Multivariate logistic regression analyses were used to adjust for potential confounders. Results: There were 238 patients who were included in the study cohort. Of these, 122 received APAP and 116 did not receive APAP. AKI or exacerbation occurred in 16.4% (n = 20) of patients in the APAP group and 19.8% (n = 23) of patients in the no APAP group (P = 0.505). After adjusting for the most important confounders, there was no significant association between APAP use and AKI (odds ratio = 1.2; 95% CI = 0.6-2.4; P = 0.639). Conclusion: APAP use in critically ill patients with sepsis may not reduce the occurrence or exacerbation of AKI.

Original languageEnglish (US)
Pages (from-to)48-53
Number of pages6
JournalAnnals of Pharmacotherapy
Volume52
Issue number1
DOIs
StatePublished - Jan 1 2018

Fingerprint

Acetaminophen
Acute Kidney Injury
Sepsis
Cohort Studies
Critical Illness
Lipid Peroxidation
Intensive Care Units
Hospitalization
Retrospective Studies
Logistic Models
Odds Ratio
Regression Analysis
Outcome Assessment (Health Care)
Kidney

Keywords

  • acetaminophen
  • acute kidney injury
  • critical care
  • intensive care
  • sepsis

ASJC Scopus subject areas

  • Pharmacology (medical)

Cite this

Effect of Acetaminophen on the Prevention of Acute Kidney Injury in Patients With Sepsis. / Patanwala, Asad E; Aljuhani, Ohoud; Bakhsh, Hussain; Erstad, Brian L.

In: Annals of Pharmacotherapy, Vol. 52, No. 1, 01.01.2018, p. 48-53.

Research output: Contribution to journalArticle

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abstract = "Background: Acute kidney injury (AKI) commonly occurs in patients with sepsis. Acetaminophen (APAP) has been shown to inhibit lipid peroxidation and, thus, may be renal protective in patients with sepsis. Objective: The objective of this study was to determine the effect of APAP on AKI in patients with sepsis. Methods: This was a retrospective cohort study conducted at 2 affiliated academic medical centers in the United States. Adult patients who were admitted to the intensive care unit with a diagnosis of severe sepsis were included. Patients were categorized based on whether APAP was received within the first 7 days of hospitalization (APAP or no APAP groups). The primary outcome measure was occurrence or increase in AKI stage from admission. Multivariate logistic regression analyses were used to adjust for potential confounders. Results: There were 238 patients who were included in the study cohort. Of these, 122 received APAP and 116 did not receive APAP. AKI or exacerbation occurred in 16.4{\%} (n = 20) of patients in the APAP group and 19.8{\%} (n = 23) of patients in the no APAP group (P = 0.505). After adjusting for the most important confounders, there was no significant association between APAP use and AKI (odds ratio = 1.2; 95{\%} CI = 0.6-2.4; P = 0.639). Conclusion: APAP use in critically ill patients with sepsis may not reduce the occurrence or exacerbation of AKI.",
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N2 - Background: Acute kidney injury (AKI) commonly occurs in patients with sepsis. Acetaminophen (APAP) has been shown to inhibit lipid peroxidation and, thus, may be renal protective in patients with sepsis. Objective: The objective of this study was to determine the effect of APAP on AKI in patients with sepsis. Methods: This was a retrospective cohort study conducted at 2 affiliated academic medical centers in the United States. Adult patients who were admitted to the intensive care unit with a diagnosis of severe sepsis were included. Patients were categorized based on whether APAP was received within the first 7 days of hospitalization (APAP or no APAP groups). The primary outcome measure was occurrence or increase in AKI stage from admission. Multivariate logistic regression analyses were used to adjust for potential confounders. Results: There were 238 patients who were included in the study cohort. Of these, 122 received APAP and 116 did not receive APAP. AKI or exacerbation occurred in 16.4% (n = 20) of patients in the APAP group and 19.8% (n = 23) of patients in the no APAP group (P = 0.505). After adjusting for the most important confounders, there was no significant association between APAP use and AKI (odds ratio = 1.2; 95% CI = 0.6-2.4; P = 0.639). Conclusion: APAP use in critically ill patients with sepsis may not reduce the occurrence or exacerbation of AKI.

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