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Drug combinations up kidney failure risk

Patients prescribed a triple combination of common painkillers and blood pressure drugs may face more than an 80% risk of kidney injury.

A double therapy combination of a diuretic and an angiotensin converting enzyme (ACE) inhibitor, or angiotensin receptor blockers (ARB) with non-steriodal anti-inflammatory drugs (NSAIDs) did not seem to increase the risk according to study published in the British Medical Journal.

Yet a triple therapy combination of the same drugs was linked to an 82% higher rate of kidney injury in the first 30 days of treatment.

After that, the risk of the condition drops to 31%.

One of the study's authors, Professor Samy Suissa from the centre for clinical epidemiology, Jewish General Hospital said: “Although antihypertensive drugs have cardiovascular benefits, vigilance may be warranted when they are used concurrently with NSAIDs.

“In particular, major attention should be paid early in the course of treatment, and a more appropriate choice among the available anti-inflammatory or analgesic drugs could therefore be applied in clinical practice.”

Over 480,000 people who were prescribed antihypertensive drugs were tracked for six years by a team of researchers from the Jewish general Hospital and McGill University in Montreal, Canada. During that time 2,215 were diagnosed with acute kidney injury that required admission to hospital or dialysis.

It is claimed adverse reactions to drugs often trigger the condition but little is known about the safety of different drug combinations.

Researchers at the London School of Hygiene and Tropical Medicine said although the study is a “step in the right direction” it could “underestimate the true burden of drug associated acute kidney injury”.

“The jury is still out on whether double drug combinations are indeed safe,” said the researchers.