title: Exposure of the elderly to potential nephrotoxic drug combinations in Belgium.
abstract: OBJECTIVE
  To count in the Belgian ambulatory prescription database Pharmanet, the number of elderly people treated with ACE inhibitors (ACEI) and/or angiotensine receptor blockers (ARB) (+/-diuretics +/- beta-blockers) who eventually also received a prescription of non-steroidal anti-inflammatory drugs (NSAID) or spironolactone.
  
  
  METHODS
  All prescriptions dispensed in community pharmacies are collected in the Pharmanet database. The data of 2005 were used. Two age groups were studied: 65-79 years (label 1) and 80+ years (label 2). The following chronic treatments (subgroups) were studied: (A) ACEI/ARB; (B) ACEI/ARB + diuretics; (C) ACEI/ARB + spironolactone; (D) ACEI/ARB + beta-blocker + diuretic and (E) ACEI/ARB + beta-blocker + spironolactone.
  
  
  RESULTS
  In 2005, 7.3% of Belgian population was chronically treated with ACEI/ARB. Twenty-five per cent of 65-79 year-old-patients (subgroup A1) and 36.15% of 80+ year-old-patients (subgroup A2) received ACEI/ARB. At least one package of NSAID or spironolactone was prescribed to subgroup A1 in 25.44 and 5.80%, respectively, and to subgroup A2 in 22.04 and 9.89%, respectively. In all studied subgroups and age categories, NSAID were coprecribed in more than 20-35% of cases.
  
  
  CONCLUSIONS
  NSAID are frequently prescribed in elderly patients treated with ACEI or ARB in combination with diuretics. Severe renal adverse effects may result in this high-risk population.
authors.affiliation: Department of Nephrology-Hypertension, Antwerp University Hospital, Belgium.
authors.forename: Hilde L E
authors.initials: HL
authors.lastname: Smets
authors.forename: Johan F F
authors.initials: JF
authors.lastname: De Haes
authors.forename: André
authors.initials: A
authors.lastname: De Swaef
authors.forename: Philippe G
authors.initials: PG
authors.lastname: Jorens
authors.forename: Gert A
authors.initials: GA
authors.lastname: Verpooten