Brief Article
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World J Gastroenterol. Feb 7, 2011; 17(5): 651-656
Published online Feb 7, 2011. doi: 10.3748/wjg.v17.i5.651
A population-based case-crossover study of polyethylene glycol use and acute renal failure risk in the elderly
Nam-Kyong Choi, Yoosoo Chang, Sun-Young Jung, Yu-Kyong Choi, Joongyub Lee, Jin-Ho Lee, Ju-Young Kim, Byung-Joo Park
Nam-Kyong Choi, Yoosoo Chang, Ju-Young Kim, Byung-Joo Park, Department of Preventive Medicine, Seoul National University College of Medicine, Seoul 110-799, South Korea
Nam-Kyong Choi, Byung-Joo Park, Medical Research Center, Seoul National University, Seoul 110-799, South Korea
Yoosoo Chang, Department of Occupational Medicine, Health Screening Center, Kangbuk Samsung Hospital, Sungkyunkwan University College of Medicine, Seoul 110-746, South Korea
Sun-Young Jung, National Evidence-Based Healthcare Collaborating Agency, Seoul 110-450, South Korea
Yu-Kyong Choi, Department of Internal Medicine, Gumi Hospital, Gumi 730-909, South Korea
Joongyub Lee, Byung-Joo Park, Medical Research Collaborating Center, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 110-799, South Korea
Jin-Ho Lee, Department of Internal Medicine, Dongguk University Ilsan Hospital, School of Medicine, Dongguk University, Goyang 410-733, South Korea
Ju-Young Kim, Department of Family Medicine, Health Promotion Center, Seoul National University Bundang Hospital, Bundang 463-707, South Korea
Author contributions: Park BJ suggested the study; Choi NK, Chang Y and Jung SY planned and designed the study; Choi NK analyzed the data; Choi NK, Chang Y, Jung SY, Choi YK, Lee J, Lee JH, Kim JY and Park BJ interpreted the results; Choi NK drafted the manuscript; Chang Y, Jung SY, Choi YK, Lee J, Lee JH and Kim JY revised the manuscript; all authors contributed to modifying the manuscript and the final editing of the paper; Park BJ is the guarantor.
Correspondence to: Byung-Joo Park, MD, MPH, PhD, Professor and Chairperson, Department of Preventive Medicine, Seoul National University College of Medicine, 103 Daehakno, Chongno-Gu, Seoul 110-799, South Korea. bjpark@snu.ac.kr
Telephone: +82-2-7408325 Fax: +82-2-7474830
Received: October 5, 2010
Revised: November 3, 2010
Accepted: November 10, 2010
Published online: February 7, 2011
Abstract

AIM: To evaluate the possibility of an association between polyethylene glycol (PEG) and acute renal failure (ARF) in elderly patients using a health insurance claims database.

METHODS: We conducted a population-based case-crossover study using information obtained from Korean Health Insurance Review and Assessment Service (HIRA) claims from January 1, 2005 to December 31, 2005 (Seoul, Korea). The study population consisted of elderly patients who received PEG prior to experiencing their first ARF-related hospitalization from April 1, 2005 to December 31, 2005. For each patient, one case and two control periods were matched. PEG use in a 2- or 4-wk window period prior to hospitalization for ARF was compared with PEG use in two earlier 2- or 4-wk control window periods. Conditional logistic regression analysis was used to estimate odds ratios (ORs) and 95% CI, adjusting for concomitant uses of diuretics, angiotensin converting enzyme inhibitors, non-steroidal anti-inflammatory drugs, antibiotics, anti-cancer drugs, and contrast media.

RESULTS: Within the HIRA database which contained 1 093 262 elderly patients, 1156 hospitalized ARF cases were identified. Among these cases, PEG was prescribed to 17 (1.5%) patients before hospitalization. The adjusted ORs when applying the 2- and 4-wk window periods were 0.4 (95% CI: 0.03-5.24) and 2.1 (95% CI: 0.16-27.78), respectively.

CONCLUSION: No increased risk of ARF was found in elderly PEG users. However, based on the limited number of study subjects, further analysis should be performed to confirm these results.

Keywords: Polyethylene glycol, Acute renal failure, Adverse drug reaction, Health insurance claims database, Case-crossover