WEDNESDAY, May 27, 2020 (HealthDay News) — Patients initiating hemodialysis often are prescribed opioids and short-acting benzodiazepines, which are associated with increased mortality risk, according to a study published online May 26 in the Clinical Journal of the American Society of Nephrology.

Abimereki D. Muzaale, M.D., M.P.H., from the Johns Hopkins University School of Medicine in Baltimore, and colleagues examined the mortality risk associated with short- and long-acting benzodiazepines and their interaction with opioids in a cohort of 69,368 adults initiating hemodialysis.

Sixteen and 5 percent of patients were dispensed a short- and long-acting benzodiazepine, respectively, within one year of hemodialysis initiation. The researchers found that codispensing of opioids and short- and long-acting benzodiazepines occurred among 26 and 8 percent, respectively, of those dispensed a benzodiazepine during follow-up. Patients with an opioid prescription were more likely to be subsequently dispensed a short- and long-acting benzodiazepine (adjusted hazard ratios, 1.66 and 1.11, respectively). Compared with those without a short-acting benzodiazepine, those dispensed a short-acting benzodiazepine had a 1.45-fold increased mortality risk; this risk was increased 1.90-fold among those with opioid codispensing. There was an inverse association for long-acting benzodiazepines with mortality (adjusted hazard ratio, 0.84); no differential risk was seen by opioid dispensing.

“Providers caring for patients undergoing hemodialysis should be given the tools needed to implement a collaborative, team-based approach for deprescribing of short-acting benzodiazepines, particularly for patients who are likely to use opioids,” the authors write.

One author disclosed financial ties to the pharmaceutical industry.

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