Serotonin-norepinephrine Reuptake Inhibitors and Acute Kidney Injury

Serotonin-norepinephrine Reuptake Inhibitors and Acute Kidney Injury

The purpose of this study is to determine if there is an excess risk of acute kidney injury (AKI) with Serotonin-norepinephrine reuptake inhibitors (SNRIs) as compared to Selective serotonin reuptake inhibitors (SSRIs), two classes of medication used for the treatment of depression.

We plan to conduct retrospective population-based cohort studies within eight administrative databases from Canada, the United States, and the United Kingdom. Within each cohort, a nested case-control analysis will be performed to estimate incidence rate ratios (RR) of AKI associated with SNRIs compared to SSRIs using conditional logistic regression, with adjustment for high-dimensional propensity scores at baseline. The overall effect across sites will then be estimated using meta-analytic methods.

Inclusion Criteria:

• A first prescription of an antidepressant of the SNRI or SSRI class of any dose between January 1, 1997 and March 31, 2010.

Exclusion Criteria:

• They were <12 years old at the time of cohort entry.
• They had less than 1 year of information in the database prior to the date of cohort entry.
• They had a prescription of an SNRI or SSRI in the year before the date of cohort entry.
• They had a prescription for both an SNRI and an SSRI on the day of cohort entry.
• They had a history of chronic kidney disease (including kidney transplantation and dialysis) or AKI in the year preceding cohort entry.
• The subject was previously included in the cohort.