Article Figures & Data
Figures
- Figure 1.
Flow diagram of included studies.
- Figure 2.
Prevalence of opioid use. 1 indicates studies that overlap in time and population.
- Figure 3.
Prevalence of benzodiazepine use. 1 and 2 indicate studies that overlap in time and population.
Tables
Number of Studies (Total = 15) Representativeness study sample represents the community of dialysis patients well 13 (87%) study collects data prospectively 13 (87%) comparison cohorts, if present, are drawn from the same source 3 (20%)a study reports clear inclusion and exclusion criteria 14 (93%) study measures actual use of opioids and benzodiazepines (versus prescription) 1 (7%) study includes prevalent and incident patients 6 (40%) all patients in the study are accounted for, and attrition was <20% 4 (27%) Results study reports baseline characteristics (e.g., age, gender, comorbidities) 14 (93%) study reports reasons for prescription of opioids and benzodiazepines 1 (7%) study reports effectiveness of opioids and benzodiazepines 2 (7%) adverse events associated with opioid/benzodiazepine use reported 7 (47%) ↵a Comparison cohort not applicable in the other 12 studies.
Study Period Country Population Dialysis Units N Dialysis Duration (years) Mean Age (years) Male (%) Comorbidities Benzodiazepine Use Opioid Use Upper 95% CI Black (%) HT CVD PVD DB N % Lower 95% CI Upper 95% CI N % Lower 95% CI Opioids Elder (2008) 1996–2001 Intl. DOPPS I prev. 308 6321 3.15 59 ± 14.5 58 15 72.5 14.0 19.6 30.0 1782 28.2 27.1 29.3 Bailey (2006) 2000 Intl. DOPPS I prev. 308 8455 4.9 ± 5.4 60 ± 14.7 57 38 73.1 15.4 21.3 32.9 803 9.5 8.9 10.1 Bailey (2004) 1997 US DOPPS I prev. 142 2998 3.4 ± 3.8 60.6 ± 15.5 53 38 84.1 18.3 26.2 46.2 538 18.0 16.7 19.4 2000 US DOPPS I prev. 142 2476 3.4 ± 3.8 60.6 ± 15.5 53 38 84.1 18.3 26.2 46.2 368 14.9 13.5 16.3 Desmet (2005) 2001 Belgium Cross-section 7 308 2.3 67 ± 13.9 56 — — 12.0 — 27.3 37 12.0 8.8 16.1 Davison (2003) 2001–2002 Canada 4 103 3.75 ± 3.2 60 ± 15.9 58 1.5 55.6 10.2 10.7 37.1 37 35.9 27.3 45.5 Carreon (2008) 2006 US Cross-section 3 75 4.4 ± 5.8 59 ± 14 67 — — 15.0 15.0 53.0 16 21.3 13.6 31.9 Both Sklar (1996) 1995 US Cross-section 1 85 2.38 60.5 ± 16.5 59 6 — — — 36.4 22 25.9 17.8 36.1 15 18.0 11.0 27.1 Unruh (2006)b 1995–1998 US CHOICE incident 81 909 0.25 57.8 ± 14.8 53 27 121 13.3 11.3 15.7 161 17.7 15.4 20.3 DMMS (1998)a 1996–1997 US USRDS incident 1035 3917 0.16 59 ± 16 53 28 >29 — — >43 310 7.9 7.1 8.8 185 4.7 4.1 5.4 Jadoul (2006) 2002–2004 Intl. DOPPS II prev. 320 12782 — — — — — — — — 2171 17.0 16.3 17.6 1078 8.4 8.0 8.9 Benzodiazepines Winkelmayer (2007)c 1996–1997 US USRDS incident 1035 3630 0.16 58.5 ± 15.6 54 29 71.0 10.0 17.3 48.6 408 11.2 10.3 12.3 Manley (2004) 2003 US DCI cross-section 200 10474 3.73 ± 4.0 60.2 ± 15.6 52 45 >26.6 — — >40.1 2765 26 25.6 27.3 Manley (2000) 1999 US Cross-section 2 238 2.83 ± 2.8 59.5 ± 16 53 21.0 — — 28.0 32 13.4 9.7 18.4 Fukuhara (2006) 2002–2004 Intl. DOPPS II prev. >300 5122 869 17.0 16.0 18.0 2002–2004 Japan DOPPS II prev. 59 1584 — — — — — — — — 308 19.4 17.6 21.4 Bailey (2007) 1999 Intl. DOPPS I prev. 307 4924 5.27 ± 5.6 58.9 ± 14.5 58 17 72.2 13.8 19.5 31.0 741 15.0 14.1 16.1 2002–2004 Intl. DOPPS II prev. 320 7760 5.19 ± 5.6 61.7 ± 14.4 58 9 77.0 16.3 24.9 32.5 1536 20.2 19.3 21.1 Risk of Outcome Study With Opioids With Benzodiazepines Poor sleep quality 1.55 (P < 0.0001)a 1.59 (P < 0.0001)a Elder (2008) 1.22 (95% CI: 0.88 to 1.69)a 1.67 (95% CI: 1.15 to 2.44)a Unruh (2006) Sexual dysfunction (pleasure) — 1.26 (P = 0.0078)a Bailie (2007) Sexual dysfunction (arousal) — 1.24 (P = 0.0134)a Bailie (2007) Hip fracture — 1.0 (0.5 to 2.0)c Winkelmayer (2007) 1.55 (P < 0.05) 1.19 (P = 0.03) Jadoul (2006) Any fracture 1.67 (0.01<P ≤ 0.05) 1.31 (P = 0.03) Jadoul (2006) Falls 3.7 (P < 0.001)a,b — Desmet (2005) Hospitalization — 1.0 (0.9 to 1.1) Fukuhara (2006) Mortality — 1.27 (1.01 to 1.59, P < 0.04) Fukuhara (2006) 1.15 (1.02 to 1.31)b Winkelmayer (2007)
In this issue
Opioid and Benzodiazepine Use in End-Stage Renal Disease: A Systematic Review
