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Open Access Research article

A population-based study on the association between acute renal failure (ARF) and the duration of polypharmacy

Yi-Ping Chang1, San-Kuei Huang2, Ping Tao34 and Ching-Wen Chien5*

Author Affiliations

1 Department of Nephrology, Taoyuan Veterans Hospital, 100 Cheng Kong Rd, Sec. 3, Taoyuan City, 33010, Taiwan

2 Bureau of National Health Insurance, No.140, Sec.3, Hsinyi Road, Taipei, 10634, Taiwan

3 Department of Medical Affairs, Taipei Veteran General Hospital, 201 Shihpai Rd. Sec. 2, Taipei, 11217, Taiwan

4 Institute of Health and Welfare Policy, National Yang Ming University, 155 Linong St., Sec. 2, Beitou, Taipei, 11221, Taiwan

5 Institute of Hospital and Health Care Administration, National Yang Ming University, 155 Li-Nong St., Sec. 2, Beitou, Taipei, 11221, Taiwan

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BMC Nephrology 2012, 13:96  doi:10.1186/1471-2369-13-96

Published: 30 August 2012

Abstract

Background

Because of the rapid growth in elderly population, polypharmacy has become a serious public health issue worldwide. Although acute renal failure (ARF) is one negative consequence of polypharmacy, the association between the duration of polypharmacy and ARF remains unclear. We therefore assessed this association using a population-based database.

Methods

Data were collected from the Taiwan National Health Insurance Research Database (NHIRD) from 2003 through 2006. The case group included patients hospitalized for ARF during 2006, but not admitted due to trauma, surgery, burn trauma, car accident, transplantation, or infectious diseases; the control group included patients hospitalized without ARF. The cumulative number of days of polypharmacy (defined as more than 5 prescriptions per day) for 1 year prior to admission was determined, with patients further subdivided into 4 categories: less than 30 days, 31–90 days, 91–180 days, and over 181 days. The dependent variable was ARF, and the control variables were age, gender, comorbidities in patients hospitalized for ARF, stay in ICUs during ARF hospitalization and site of operation for prior admissions within one month of ARF hospitalization.

Results

Of 20,790 patients who were admitted to hospitals for ARF in 2006, 12,314 (59.23 %) were male and more than 60 % were older than 65 years. Of patients with and without ARF, 16.14 % and 10.61 %, respectively, received polypharmacy for 91–180 days and 50.22 % and 24.12 %, respectively, for over 181 days. A statistical model indicated that, relative to patients who received polypharmacy for less than 30 days, those who received polypharmacy for 31–90, 91–180 and over 181 days had odds ratios of developing ARF of 1.33 (p<0.001), 1.65 (p<0.001) and 1.74 (p<0.001), respectively.

Conclusions

We observed statistically significant associations between the duration of polypharmacy and the occurrence of ARF.