Cannabis Use and Risk of Acute Kidney Injury in Patients with Advanced Chronic Kidney Disease Transitioning to Dialysis
Potukuchi P.K. Moradi H. Park F. Kaplan C. Thomas F. Dashputre A.A. Sumida K. Molnar M.Z. Gaipov A. Gatwood J.D. Rhee C. Streja E. Kalantar-Zadeh K. Kovesdy C.P.
1 February 2023Mary Ann Liebert Inc.
Cannabis and Cannabinoid Research
2023#8Issue 1138 - 147 pp.
Background: The current social and legal landscape is likely to foster the medicinal and recreational use of cannabis. Synthetic cannabinoid use is associated with acute kidney injury (AKI) in case reports; however, the association between natural cannabis use and AKI risk in patients with advanced chronic kidney disease (CKD) is unknown. Materials and Methods: From a nationally representative cohort of 102,477 U.S. veterans transitioning to dialysis between 2007 and 2015, we identified 2215 patients with advanced CKD who had undergone urine toxicology (UTOX) tests within a year before dialysis initiation and had inpatient serial serum creatinine levels measured within 7 days after their UTOX test. The exposure of interest was cannabis use compared with no use as ascertained by the UTOX test. We examined the association of this exposure with AKI using logistic regression and inverse probability of treatment weighting with extensive adjustment for potential confounders. Results: The mean age of the overall cohort was 61 years; 97% were males, 51% were African Americans, 97% had hypertension, 76% had hyperlipidemia, and 75% were diabetic. AKI occurred in 56% of the cohort, and in multivariable-adjusted analysis, cannabis use (when compared with no substance use) was not associated with significantly higher odds of AKI (odds ratio 0.85, 95% confidence interval 0.38-1.87; p=0.7). These results were robust to various sensitivity analyses. Conclusions: In this observational study examining patients with advanced CKD, cannabis use was not associated with AKI risk. Additional studies are needed to characterize the impact of cannabis use on risk of kidney disease and injury.
acute kidney injury , cannabinoids , chronic kidney disease , end-stage kidney disease , multinomial propensity score weights , urine toxicology
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Division of Nephrology, Department of Medicine, University of Tennessee Health Science Center, Memphis, TN, United States
Institute for Health Outcomes and Policy, College of Graduate Health Sciences, University of Tennessee Health Science Center, Memphis, TN, United States
Division of Nephrology and Hypertension, University of California-Irvine, Orange, CA, United States
Nephrology Section, Long Beach Va Medical Center, Long Beach, CA, United States
Department of Pharmaceutical Sciences, College of Pharmacy, University of Tennessee Health Science Center, Memphis, TN, United States
Usc Gehr Family Center for Health Systems Science and Innovation, Keck School of Medicine of Usc, Los Angeles, CA, United States
Division of Biostatistics, Department of Preventive Medicine, College of Medicine, University of Tennessee Health Science Center, Memphis, TN, United States
Division of Nephrology and Hypertension, Department of Medicine, University of Utah, Salt Lake City, UT, United States
Department of Medicine, Nazarbayev University School of Medicine, Nur-Sultan, Kazakhstan
Department of Clinical Pharmacy and Translational Science, College of Pharmacy, University of Tennessee Health Science Center, Nashville, TN, United States
Division of Nephrology and Hypertension, Harold Simmons Center for Chronic Disease Research and Epidemiology, University of California-Irvine, Orange, CA, United States
Nephrology Section, Memphis Va Medical Center, Memphis, TN, United States
Division of Nephrology
Institute for Health Outcomes and Policy
Division of Nephrology and Hypertension
Nephrology Section
Department of Pharmaceutical Sciences
Usc Gehr Family Center for Health Systems Science and Innovation
Division of Biostatistics
Division of Nephrology and Hypertension
Department of Medicine
Department of Clinical Pharmacy and Translational Science
Division of Nephrology and Hypertension
Nephrology Section
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