Second-Generation Antipsychotics Can Increase Risk of Chronic Kidney Disease

Antipsychotic medications have the potential to fight against acute psychosis, including chronic psychotic disorder such as schizophrenia, bipolar affective disorder and insufficiently responding to unipolar depression. But, sometimes some of the antipsychotics can worsen the condition. Similarly, all of the atypical antipsychotics or the second-generation antipsychotics (SGA) except ‘aripiprazole’ can mild to moderately increase the risk of developing chronic kidney disease (CKD), says a recent study conducted by the researchers from Denmark. The findings of the study have been published in The British Medical Journal (BMJ).

The researchers from different universities of Denmark including the University of Southern Denmark, Odense University Hospital, and Department of Psychiatry Aabenraa have conducted a population-based case-control study. The team aimed to find a link between SGA and Chronic Kidney Disease (CKD) which is also known as kidney failure that occurs when the kidney cannot filter the blood and results in malfunctioning of kidneys or the gradual loss of kidney functions over time.

The investigators have collected a sample that was comprised of 21,434 patients with CKD that has reached approximately 14% from 1988 to 2004, according to an estimation published by the National Institute of Diabetes and Digestive and Kidney Disease (NIDDK). NIDDK has also specified that overall more than 661,000 Americans are suffering from kidney failure, of these 468,000 people are on dialysis and nearly 193,000 are living with a kidney transplant.

Source: University of Manitoba (UOM)

The team compared those 21,434 CKD patients with another group of non-CKD people. The second group had 85,576 participants.

All the information including diagnosis, routinely check-up, and prescription about CKD patients were collected from the Danish National Prescription Register and the Danish National Patient Register from 2001 to 2015.

The investigators used the conditional regression model (CRM) to find out the association between CKD and SGAs that can be defined as a group of antipsychotic drugs mainly used to treat a psychiatric disorder. These drugs are used as a tranquilizer or a medical drug that is used to reduce the levels of anxiety or tension.

Source: Onward Mental Health

After the compilation of the findings gained from the prescriptions of the patients, the team found out that both short and long term use of SGAs is linked with an increased risk of developing metabolic disturbances as well as chances of catching CKDs.

The team also determined that those people who have recently been on non-steroidal anti-inflammatory drugs, prior use of lithium (an FDA approved antipsychotic medication), were not significantly enhance the risk of developing CKD.

It was also found that two of the SGAs known as ‘clozapine’ were significantly linked with the CKDs whereas another SGA known as ‘aripiprazole’ did not trigger the disease. The team did not found any clear evidence that can define the responses of doses of SGAs.

Source: The BMJ

The investigators also determined those factors that did not heighten the risk of CKDs. The factors included NSAID use, prior lithium use, and prior Acute Kidney Injury (AKI). The CKDs can also be dangerous for those people with an underlying condition known as diabetes mellitus (DM). The current study has found that SGAs have increased 52% chances of developing CKDs in the diabetic population in comparison to non-diabetic.

Risk Factors

The Indian researchers have also explained that the long term use of antipsychotics can result in two of the mental condition that involves memory loss, including dementia and delirium.

Overall, the present study suggested that taking SGAs can enhance the risk of developing CKDs as compared to those people who did not use SGAs.

Still, there is a need for further research to find clear evidence of the association between CKDs and SGAs because the results may vary due to the confounding variables or extraneous variables, that are independent but influence the effects of both independent and dependent variables in the research study, such as demographic characteristics including age, and gender. The variables that can be the factor causing CKDs such as obesity, smoking, and lifestyle did not include in the present study.

Source: Onward Mental Health

This study was funded by two grants: one from the Beckett Foundation (Copenhagen, Denmark) and Hede-Nielsen Family Foundation (Horsens, Denmark).

Previous Study on SGAs

The earlier study, published by the BMJ has suggested that exposure to the SGAs in those patients with CKDs resulted in a psychiatric disorder known as ‘schizophrenia’, a severe chronic psychological disorder that adversely influences a person’s ability to think, feel and behave. People suffering from schizophrenia may appear to have completely lost touch with reality and rationality.

Source: Psychiatric Times

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