Table 3.
Use of nephrotoxic agents in patients with renal impairment or chronic kidney disease by eGFR category
| Lowest eGFR (renal impairment) or confirming eGFR (chronic kidney disease) category (mL/min per 1.73 m2) in study period | ||||
|---|---|---|---|---|
| <60 | 30–59 | 15–29 | <15 | |
| Patients with renal impairmenta (n, %) | 5334 (61%) | 3488 (40%) | 1220 (14%) | 626 (7%) |
| Any nephrotoxic agent before lowest eGFR value | 2109 (40%) | 1472 (42%) | 465 (38%) | 172 (27%) |
| Any nephrotoxic agent within 12 mo of lowest eGFRb | 2057 (39%) | 1497 (43%) | 413 (34%) | 147 (23%) |
| Any IV BP before confirming eGFR | 1981 (37%) | 1404 (40%) | 430 (35%) | 147 (23%) |
| Any IV BP within 12 mo of confirming eGFRb | 1862 (35%) | 1402 (40%) | 365 (30%) | 95 (15%) |
| IV BP plus other nephrotoxic agent within 12 mo | 205 (4%) | 129 (4%) | 55 (5%) | 21 (3%) |
| Time to lowest eGFR (months), median (Q1, Q3) | 2.3 (0.4, 11.5) | 3.4 (0.7, 12.9) | 1.2 (0.2, 7.3) | 1.0 (0.2, 6.0) |
| Time after lowest eGFR (months, maximum 360), median (Q1, Q3) | 10.5 (3.8, 11.8) | 9.9 (3.4, 11.8) | 11.8 (5.2, 11.8) | 8.8 (3.7, 11.8) |
| Patients with chronic kidney diseasec (n, %) | 3399 (50%) | 2006 (29%) | 944 (14%) | 449 (7%) |
| Any nephrotoxic agent before confirming eGFR | 1537 (45%) | 999 (50%) | 407 (43%) | 131 (29%) |
| Any nephrotoxic agent within 12 mo of confirming eGFRb | 1567 (46%) | 962 (48%) | 455 (48%) | 150 (33%) |
| Any IV BP before confirming eGFR | 1466 (43%) | 967 (48%) | 386 (41%) | 113 (25%) |
| Any IV BP within 12 mo of confirming eGFRb | 1441 (42%) | 911 (45%) | 423 (45%) | 107 (24%) |
| Use of IV BP plus other nephrotoxic agent within 12 mo | 186 (5%) | 87 (4%) | 70 (7%) | 29 (6%) |
| Time to lowest eGFR (mo), median (Q1, Q3) | 7.7 (4.4, 16.9) | 10.0 (5.3, 19.4) | 5.6 (3.9, 12.6) | 4.9 (3.6, 11.5) |
| Time after lowest eGFR (mo, maximum 360), median (Q1, Q3) | 10.0 (3.6, 11.8) | 9.3 (3.2, 11.8) | 11.8 (5.2, 11.8) | 8.3 (3.0, 11.8) |
eGFR, estimated glomerular filtration rate; IV BP, intravenous bisphosphonate.
a
In the total patient sample (N = 8767).
b
Patients not required to have 12 complete months of follow up.
c
Percentage among all patients with at least two eGFR values at least 90 days apart (N = 6813).