Journal article
Understanding Antihypertensive Medication Use after Living Kidney Donation through Linked National Registry and Pharmacy Claims Data
American journal of nephrology, Vol.40(2), pp.174-183
01/01/2014
DOI: 10.1159/000365157
PMID: 25196154
Abstract
Background: Use of antihypertensive medications (AHM) after living kidney donation is not well described. Methods: We examined a database wherein national transplant registry data for 4,650 living kidney donors in 1987-2007 were linked to pharmacy claims from a US private health insurer (2000-2007 claims) to identify post-donation AHM fills. Cox regression with left-and right-censoring was used to estimate the frequencies and relative likelihood (adjusted hazards ratios, aHR) of post-donation AHM fills according to donor demographic traits. Medication possession ratio (MPRs), defined as (days of AHM dispensed)/(days observed), were also compared among donors and non-donor general beneficiaries. Results: Overall, 17.8% of the sample filled at least one AHM by 5 years post-donation. As compared with White living donors, African-Americans had 37% higher relative likelihood of any AHM use after donation (aHR 1.37, p < 0.0007), including significantly higher likelihoods of filling diuretics (aHR 2.25, p < 0.0001), ACEi/ARBs (aHR 1.46, p < 0.01), calcium channel blockers (aHR 1.56, p = 0.03), and vasodilators/other agents (aHR 2.17, p = 0.03). MPRs for any AHM and subcategories were lower among donors compared with age-and sex-matched non-donors. However, AHM MPRs rose in donors with multiple hypertension diagnoses, and prescription fill exposure for all AHM classes except diuretics was similar among donors and general non-donors with >= 3 hypertension diagnoses. Conclusions: While AHM requirements are lower after kidney donation than among unscreened general persons, racial variation in AHM use occurs in privately insured donors. Demonstration of pharmaceutical care needs of insured donors supports the need for long-term follow-up and healthcare access for all donors. (C) 2014 S. Karger AG, Basel
Details
- Title: Subtitle
- Understanding Antihypertensive Medication Use after Living Kidney Donation through Linked National Registry and Pharmacy Claims Data
- Creators
- Krista L. Lentine - Saint Louis UniversityMark A. Schnitzler - Saint Louis UniversityAmit X. Garg - Western UniversityHuiling Xiao - Center for Outcomes Research and Clinical EpidemiologyDavid Axelrod - Dartmouth CollegeJanet E. Tuttle-Newhall - Saint Louis UniversityDaniel C. Brennan - Washington University in St. LouisDorry L. Segev - Saint Louis University
- Resource Type
- Journal article
- Publication Details
- American journal of nephrology, Vol.40(2), pp.174-183
- Publisher
- Karger
- DOI
- 10.1159/000365157
- PMID
- 25196154
- ISSN
- 0250-8095
- eISSN
- 1421-9670
- Number of pages
- 10
- Grant note
- R01DK096008 / NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Diabetes & Digestive & Kidney Diseases (NIDDK) R01-DK096008 / National Institutes of Health (NIH)/National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Diabetes & Digestive & Kidney Diseases (NIDDK)
- Language
- English
- Date published
- 01/01/2014
- Academic Unit
- Surgery
- Record Identifier
- 9984322813702771
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