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Fluoroquinolone + ACE inhibitor: acute kidney injury

机译:氟代喹啉+ ACE抑制剂:急性肾损伤

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In early 2018, a series of 11 reports of acute kidney injury attributed to a combination of ciprofloxacin, a fluoroquinolone, with enalapril was identified in the pharmacovigilance database of the Uppsala Monitoring Centre of the World Health Organization (WHO) (1).These patients, on long term treatment with enalapril, an angiotensin converting enzyme (ACE) inhibitor, had risk factors for renal failure. However, acute kidney injury only occurred after treatment initiation with ciprofloxacin (1). Fluoroquinolones carry a risk of intrinsic ("organic") renal failure. ACE inhibitors carry a risk of prerenal ("functional") renal failure, because their renin-inhibitory action disrupts the regulation of glomerular blood flow (2,3). The combination of these two drugs increases the risk of renal failure. Consistent with these reports, a case-control study using an insurance database of men aged 40 to 85 years in the United States, showed a 2-fold greater risk of acute kidney injury in patients exposed to a fluoroquinolone compared to controls, and a 4.5-fold greater risk when the fluoroquinolone was combined with an ACE inhibitor (95% confidence interval: 2.8-7.0) (1).
机译:在2018年初,在世界卫生组织乌普萨拉监测中心(WHO)(1)的药物检测中心的药物检测数据库中,鉴定了一种急性肾损伤的11次急性肾损伤的报告。(1)(1)。这些患者,在长期处理与Enalapril,血管紧张素转换酶(ACE)抑制剂的危险因素有肾功能衰竭。然而,急性肾损伤仅发生在治疗开始后用环丙沙星(1)。氟喹诺酮含有内在(“有机”)肾功能衰竭的风险。 ACE抑制剂患有捕蝇(“功能”)肾功能衰竭的风险,因为它们的肾素抑制作用破坏了肾小球血流量的调节(2,3)。这两种药物的组合增加了肾衰竭的风险。与这些报告一致,在美国40至85岁的男性保险数据库中的案例对照研究表明,与对照相比,暴露于氟代喹啉的患者的急性肾损伤的风险2倍,4.5 - 当氟代喹啉与ACE抑制剂组合时更大的风险(95%置信区间:2.8-7.0)(1)。

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    《Prescrire international》 |2018年第199期|共1页
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  • 中图分类 药学;
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