Self-Reported Medication Use and Urinary Drug Metabolites in the German Chronic Kidney Disease (GCKD) Study
| Autor: | Robert P. Mohney, Peter J. Oefner, Peggy Sekula, Kai-Uwe Eckardt, Gckd Study Investigators, Anna Köttgen, Johanna Mielke, Matthias Wuttke, Fruzsina Kotsis, Edward D. Karoly, Michael S. Becker, Pascal Schlosser, Ulla T. Schultheiss |
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| Rok vydání: | 2021 |
| Předmět: |
Male
Drug medicine.medical_specialty Urinary system media_common.quotation_subject Metabolite Urine Sensitivity and Specificity Mass Spectrometry Medication Adherence Cohort Studies chemistry.chemical_compound Germany Internal medicine medicine Humans Clinical Epidemiology Renal Insufficiency Chronic Medical prescription Aged media_common business.industry General Medicine Middle Aged Ibuprofen medicine.disease Acetaminophen Pharmaceutical Preparations chemistry Nephrology Polypharmacy Female Self Report business medicine.drug Kidney disease |
| Zdroj: | J Am Soc Nephrol |
| ISSN: | 1533-3450 1046-6673 |
| Popis: | Background Polypharamacy is common among patients with chronic kidney disease (CKD), but little is known about urinary excretion of many drugs and their metabolites among CKD patients. Methods To evaluate self-reported medication use in relation to urine drug metabolite levels in a large cohort of CKD patients, the Germany Chronic Kidney Disease study, we ascertained self-reported use of 158 substances and 41 medication groups and coded active ingredients according to the Anatomical Therapeutic Chemical classification system. We used a nontargeted mass spectrometry-based approach to quantify metabolites in urine; calculated specificity, sensitivity, and accuracy of medication use and corresponding metabolite measurements; and used multivariable regression models to evaluate associations and prescription patterns. Results Among 4885 participants, there were 108 medication-drug metabolite pairs based on reported medication use and 78 drug metabolites. Accuracy was excellent for measurements of 36 individual substances in which the unchanged drug was measured in urine (median, 98.5%; range 61.1%-100%). For 66 pairs of substances and their related drug metabolites, median measurement-based specificity and sensitivity were 99.2% (range 84.0%-100%) and 71.7% (range 1.2%-100%), respectively. Commonly prescribed medications for hypertension and cardiovascular risk reduction-including angiotensin-II receptor blockers, calcium channel blockers, and metoprolol-showed high sensitivity and specificity. Although self-reported use of prescribed analgesics (acetaminophen, ibuprofen) was |
| Databáze: | OpenAIRE |
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