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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
Patients with chronic kidney disease (CKD) need to avoid drugs with potential renal toxicity and CKD-stage contraindications. However, certain potentially harmful drugs such as benzodiazepines, opioids, antipsychotics, mood stabilizers may evade such classifications. Real-world evidence from Japan on prescribing patterns of such potentially harmful drugs and their association with kidney function decline remains limited.
We conducted a cross-sectional and longitudinal analysis using the DeSC healthcare claims database covering 2015 through 2024 (~18 million beneficiaries). From this source, we identified 1,026,215 individuals with at least three years of observation. Non-CKD and CKD stages G1–G5 were assigned from laboratory data according to CKD guidelines using serum creatinine and/or proteinuria. “Potentially harmful drugs” were defined according to Paik et al. (2021): non-benzodiazepine hypnotics, benzodiazepines, opioids, antipsychotics, mood stabilizers, cholinesterase inhibitors, first-generation antihistamines, antispasmodic agents, selective serotonin reuptake inhibitors, and tricyclic antidepressants. Exposure meant six or more prescriptions of any listed agent. Among 28,295 unique medicines, 2,697 were classified as potentially harmful. The primary outcome was a ≥30% decline in estimated glomerular filtration rate (eGFR) from cohort entry, determined by regression across three or more eGFR measurements. Time to this decline was analyzed with Kaplan–Meier curves and Cox proportional hazards models. We also described annual trends in harmful-drug exposure between 2015 and 2022.
The cohort contributed 4,418,161 person-years. Individuals (n=1,026,215; 59.4% females; mean age 66 years) included non-CKD (n=863,275; 60.3%, 65 years), G1 (n=1,205; 43.3%, 62 years), G2 (n=9,264; 39.4%; 69 years), G3 (n=149,504; 55.6%; 73.3 years), G4 (n=2,711; 52.2%; 78 years), and G5 (n=256; 44.9%; 70 years). The prevalence of harmful-drug exposure decreased from 38.0% in 2015 to 28.6% in 2022. Kaplan–Meier curves showed lower survival free of ≥30% eGFR decline among exposed patients overall and within both CKD and non-CKD strata (log-rank p<0.0001). In stage-wise Cox models adjusted for age and sex, harmful-drug exposure was associated with a higher hazard of ≥30% eGFR decline in non-CKD (HR 1.62, 95% CI 1.55–1.69) and in G3 (HR 1.41, 95% CI 1.32–1.51). Estimates in G1, G2, G4, and G5 were not statistically significant.
In this large Japanese claims cohort, exposure to medications flagged as potentially harmful for renal outcomes was common but slightly declined over time. Harmful-drug exposure was associated with faster kidney function decline particularly in non-CKD and G3. Our findings support importance of routine medication review and increased CKD stage-awareness when prescribing in patients at risk of CKD progression.
