Potential adverse effects of a low-dose aspirin-diuretic combination on kidney function.
OBJECTIVE
Low-dose aspirin and diuretics are commonly co-utilized in patients with cardiovascular diseases. The objective of this study was to investigate the effects of a low-dose aspirin-diuretic drug combination on renal function.


METHODS
In this cross-sectional retrospective study, all patients, excluding those on renal dialysis, admitted to the Internal Medicine Department of the Al-Watani Hospital, Nablus, Palestine, were included in the study. Medical data were obtained from patients' medical files. Estimation of creatinine clearance was carried out using the Cockcroft-Gault equation. Patients on the target drug combination were compared with patients who were not receiving the target drug combination. An independent paired t-test and 1-way ANOVA were used to test for significance between groups. Statistics were carried out using the Statistical Package for Social Sciences (SPSS), version 13.


RESULTS
A total of 340 subjects (54.4% men) were included in the study. There were 90 patients on the target drug combination and designated as the study group. Of the remaining 250 patients comprising the control group, 114 received none of the target drugs and 136 received only one target medication. There was a significant (p < 0.001) difference in the levels of creatinine clearance between the two groups. Patients on the target drug combination had significantly lower creatinine clearance levels than those in the control group. Men in the study group had lower creatinine clearances than men in the control group and similar results were found for women. Patients in the study group with > or = 2 chronic diseases, had lower creatinine clearances than patients in the control group with > or = 2 chronic diseases. Similar results were found in patients with < 2 chronic diseases.


CONCLUSIONS
Administration of a low-dose aspirin-diuretic drug combination was associated with significantly lower creatinine clearance levels. This finding was independent of gender and the number of chronic diseases present. Monitoring kidney function in patients receiving this drug combination is recommended.
Sweileh
W M
WM
Clinical Pharmacology, College of Pharmacy, Clinical Pharmacy Graduate Program, An-Najah National University, Nablus, Palestine. waleedsweileh@najah.edu
D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects / Q000627:therapeutic use; D001241:Aspirin / Q000009:adverse effects* / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000188:drug therapy; D003404:Creatinine / Q000493:pharmacokinetics; D003430:Cross-Sectional Studies; D004232:Diuretics / Q000009:adverse effects* / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007668:Kidney / Q000187:drug effects* / Q000503:physiopathology; D007674:Kidney Diseases / Q000139:chemically induced / Q000503:physiopathology; D007677:Kidney Function Tests / Q000379:methods; D016015:Logistic Models; D008297:Male; D008657:Metabolic Clearance Rate; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012737:Sex Factors; D013607:Tablets
D000894:Anti-Inflammatory Agents, Non-Steroidal; D004232:Diuretics; D013607:Tablets; D003404:Creatinine; D001241:Aspirin