Effect of Colchicine Use and Usual Care Alone on the Rate of Progression to Chronic Kidney Disease and Mortality in Patients with Heat-Related Injury

TL;DR

Using colchicine after heat-related injury may help reduce the risk of chronic kidney disease progression and dialysis, but it does not affect overall mortality.

Contribution

This study is the first to show a potential renoprotective effect of colchicine in patients with heat-related injury.

Findings

Colchicine use was linked to a lower risk of CKD progression and dialysis initiation.

No significant effect of colchicine on all-cause mortality was observed.

The findings suggest a potential role for anti-inflammatory therapy in preventing long-term kidney damage after heat-related injury.

Abstract

What are the main findings?
Colchicine use after heat-related injury was associated with a reduced long-term risk of CKD progression and dialysis initiation.No significant association was observed between colchicine use and all-cause mortality in HRI patients.

Colchicine use after heat-related injury was associated with a reduced long-term risk of CKD progression and dialysis initiation.

No significant association was observed between colchicine use and all-cause mortality in HRI patients.

What are the implications of the main findings?
Anti-inflammatory therapy may represent a potential strategy for mitigating long-term renal sequelae following heat-related injury.These findings support further prospective studies to clarify the role of colchicine in post-HRI renal protection.

Anti-inflammatory therapy may represent a potential strategy for mitigating long-term renal sequelae following heat-related injury.

These findings support further prospective studies to clarify the role of colchicine in post-HRI renal protection.

Background: Heat-related injury (HRI) induces systemic inflammation and is associated with acute kidney injury and subsequent progression to chronic kidney disease (CKD). Currently, no established pharmacological intervention exists to prevent long-term renal deterioration following HRI. This study aimed to evaluate the association between colchicine use and long-term renal outcomes in patients with HRI. Methods: We conducted a nationwide retrospective cohort study using data from the Taiwanese National Health Insurance Research Database. Adult patients diagnosed with HRI between 2000 and 2015 were identified. Colchicine users were defined as patients who received colchicine within 7 days after the index HRI event and were compared with propensity score-matched nonusers. The primary outcomes included CKD progression, initiation of hemodialysis, CKD-related mortality, and all-cause mortality. Results: A total of 4961 eligible patients with HRI were included in the analysis. During a median follow-up of 9.65 years, colchicine use was associated with a significantly lower risk of CKD progression, initiation of hemodialysis, and CKD-related mortality compared with nonuse. No significant association was observed between colchicine use and all-cause mortality. Conclusions: Colchicine use following HRI was associated with favorable long-term renal outcomes, including reduced risks of CKD progression and dialysis. Although causal inference cannot be established due to the observational design, these findings suggest a potential renoprotective association of colchicine in patients with HRI.

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