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  1. Kam Uppell
  1. Correspondence to Kam Uppell;

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Triple therapy with antihypertensives and NSAIDs linked to acute kidney injury

Triple therapy combination consisting of diuretics with ACE inhibitors or angiotensin receptor blockers (ARBs) and non-steroidal anti-inflammatory drugs (NSAIDs) is associated with an increased risk of acute kidney injury according to a UK study.

In a retrospective cohort study, researchers assessed whether double therapy consisting of a diuretic or an ACE inhibitor or an ARB with the addition of an NSAID, and triple therapy consisting of a diuretic plus an ACE inhibitor or an ARB in addition to an NSAID increased the risk of acute kidney injury. A total of 487 372 people using antihypertensive drugs between 1 January 1997 and 31 December 2008 were identified from the UK Clinical Practice Research Datalink. Reporting their finding in the British Medical Journal, the researchers say that during a mean follow-up of 5.9 years, 2215 cases of acute kidney injury were identified (incidence rate 7/10 000 person years). The researchers say, “Current use of a triple therapy combination was associated with an increased rate of acute kidney injury (rate ratio 1.31, 95% CI 1.12 to 1.53). In secondary analyses, the highest risk was observed in the first 30 days of use (rate ratio 1.82, 95% …

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  • Competing interests None.

  • Provenance and peer review Not commissioned; internally peer reviewed.