{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T11:32:30Z","timestamp":1791286350512,"version":"4.1.0"},"reference-count":35,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:00:00Z","timestamp":1756339200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100008530","name":"European Regional Development Fund","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008530","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100016120","name":"Departamento de Salud, Gobierno de Navarra","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100016120","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Clin Pharmacol"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>\u201cTriple whammy\u201d (TW) refers to the concomitant use of diuretics, renin\u2010angiotensin\u2010aldosterone system inhibitors (RAASI) and non\u2010steroidal anti\u2010inflammatory drugs (NSAIDs). The aim of this article is to analyse the association between TW exposure and acute kidney injury (AKI), among other morbi\u2010mortality outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We included studies published up to August 2023 in the Cochrane Library, Medline or EMBASE, among others. The risk of AKI within 12\u2009months after TW\n                      <jats:italic>vs<\/jats:italic>\n                      . not exposed to TW was the main outcome.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We included five case\u2013control studies, involving 410\u2009130 participants. The risk of AKI was significantly higher among those exposed to TW\n                      <jats:italic>vs<\/jats:italic>\n                      . not exposed (odds ratio [OR] 2.01, 95% confidence interval [CI] 1.30\u20133.10; four studies;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      : 90%; low certainty of evidence). Three studies provided data on all\u2010cause mortality, not showing a significantly higher risk with TW exposure (very low certainty of evidence).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The available evidence reveals that TW may lead to a significantly higher risk of AKI and related hospitalizations, with no detrimental effect on mortality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/bcp.70263","type":"journal-article","created":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T23:44:21Z","timestamp":1756424661000},"page":"3031-3041","source":"Crossref","is-referenced-by-count":7,"title":["Acute kidney injury and morbi\u2010mortality associated with \u201ctriple whammy\u201d combination: Systematic review and meta\u2010analysis"],"prefix":"10.1002","volume":"91","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1811-9099","authenticated-orcid":false,"given":"Dulce Mar\u00eda","family":"Calvo","sequence":"first","affiliation":[{"name":"Autonomous University of Barcelona (UAB)  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9143-5709","authenticated-orcid":false,"given":"Luis Carlos","family":"Saiz","sequence":"additional","affiliation":[{"name":"Innovation and Organization Unit Navarre Health Service  Pamplona Spain"},{"name":"Navarra Institute for Health Research (IdiSNA)  Pamplona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2272-7086","authenticated-orcid":false,"given":"Leire","family":"Leache","sequence":"additional","affiliation":[{"name":"Navarra Institute for Health Research (IdiSNA)  Pamplona Spain"},{"name":"Pharmacy and Services Sub\u2010Directorate Navarre Health Service  Pamplona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7700-7911","authenticated-orcid":false,"given":"Maria Concepci\u00f3n","family":"Celaya","sequence":"additional","affiliation":[{"name":"Navarra Institute for Health Research (IdiSNA)  Pamplona Spain"},{"name":"Pharmacy and Services Sub\u2010Directorate Navarre Health Service  Pamplona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3229-6614","authenticated-orcid":false,"given":"Marta","family":"Guti\u00e9rrez\u2010Valencia","sequence":"additional","affiliation":[{"name":"Innovation and Organization Unit Navarre Health Service  Pamplona Spain"},{"name":"Navarra Institute for Health Research (IdiSNA)  Pamplona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,8,28]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.2000.tb125548.x"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41374\u2010020\u20100473\u20109"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/papr.12467"},{"issue":"2","key":"e_1_2_10_5_1","first-page":"98","article-title":"Answering the question: is metamizole a non\u2010steroidal anti\u2010inflammatory or not?","volume":"42","author":"Carrillo\u2010Torres O","year":"2019","journal-title":"Rev Mex Anest"},{"key":"e_1_2_10_6_1","first-page":"627","volume-title":"Tratado de geriatria para residentes [internet]","author":"Carracedo AG","year":"2006"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccc.2020.11.013"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.0306\u20105251.2004.2188.x"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2015.101"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1248\/yakushi.19\u201000096"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.3324"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736%2805%2970238\u20105"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2004090740"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1179\/acb.2007.077"},{"key":"e_1_2_10_15_1","unstructured":"Consulta Interactiva del SNS. 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