Denise Menti

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Neslihan Deveci

Fırat University

Marie Griemsmann

Medizinische Hochschule Hannover

Heiner Wedemeyer

Medizinische Hochschule Hannover

Benjamin Maasoumy

Medizinische Hochschule Hannover

Tammo Lambert Tergast

Medizinische Hochschule Hannover

Markus Cornberg

Medizinische Hochschule Hannover

Anke Kraft

Medizinische Hochschule Hannover

Dirk O. Stichtenoth

Medizinische Hochschule Hannover

Benjamin Schulte

Lucas Hüffner

Center for Experimental and Clinical Infection Research

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Medizinische Hochschule Hannover

German Center for Infection Research

German Liver Foundation

Center for Experimental and Clinical Infection Research

Helmholtz Centre for Infection Research

Centre for Individualised Infection Medicine

Ruhr University Bochum

University of Duisburg-Essen

German Center for Lung Research

ERN RARE-LIVER

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Application of CT-contrast media is not associated with a higher risk for acute kidney injury in patients with decompensated liver cirrhosis

Journal of Hepatology (2022)

Tammo Lambert Tergast Marie Griemsmann Benjamin Schulte Denise Menti Neslihan Deveci

10.1016/s0168-8278(22)02075-x

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Metamizole-associated risks in decompensated hepatic cirrhosis

Deutsches Ärzteblatt international (2022)

Benjamin Schulte Tammo Lambert Tergast Marie Griemsmann Denise Menti Neslihan Deveci

Because of the increased risk of acute renal failure (ARF), the use of cyclooxygenase (COX) inhibitors is not recommended in patients with decompensated hepatic cirrhosis. Metamizole is not a classic COX inhibitor, but there are insufficient data to support its safe use. In this study, we investigate the effect of metamizole on the risk of ARF in these patients.Metamizole use, ARF incidence, and patient mortality were examined in a large, retrospective, exploratory cohort and validated with data from a prospective registry.523 patients were evaluated in the exploratory cohort. Metamizole use at baseline was documented in 110 cases (21%) and was independently associated with the development of ARF, severe (grade 3) ARF, and lower survival without liver transplantation at follow-up on day 28 (HR: 2.2, p < 0.001; HR: 2.8, p < 0.001; and HR: 2.6, p < 0.001, respectively). Interestingly, the risk of ARF depended on the dose of metamizole administered (HR: 1.038, p < 0.001). Compared to patients who were treated with opioids, the rate of ARF was higher in the metamizole group (49% vs. 79%, p = 0.014). An increased risk of ARF with metamizole use was also demonstrated in the independent validation cohort (p < 0.001).Metamizole therapy, especially at high doses, should only be used with a high level of caution in patients with decompensated cirrhosis.

Metamizole

10.3238/arztebl.m2022.0280

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Citations (3)