Electronic Thesis and Dissertation Repository


Master of Science


Epidemiology and Biostatistics


Dr. Amit Garg


Older adults are frequently prescribed atypical antipsychotic drugs and may be at a risk for kidney-related adverse events. This population-based retrospective cohort study examined the 90-day risk of acute kidney injury (AKI) and the potential reasons for AKI in 96,471 matched pairs of older adults who received and who did not receive a new atypical antipsychotic drug prescription from 2003 to 2011 in Ontario. Atypical antipsychotic drug use was associated with a higher risk of hospitalization with AKI (relative risk (RR) 2.06 [95% confidence interval (CI) 1.85–2.29]). The drug use was also associated with potential reasons for AKI including hypotension (RR 2.16 [95% CI 1.81–2.57]), acute urinary retention (RR 2.15 [95% CI 1.78–2.60]), and neuroleptic malignant syndrome/rhabdomyolysis (RR 1.44 [95% CI 1.06–1.96]). Residual confounding is unlikely to explain the observed associations entirely. This knowledge informs prescribing practice and may help identify a drug-induced reason for AKI.