To the Editor: Dr Mehta and colleagues1 reported that patients in the intensive care unit who received diuretics for acute renal failure (ARF) had a higher risk of dying and nonrecovery of renal function than those who did not.
I am concerned that the authors' use of the odds ratios may misrepresent the difference in risk of death between the 2 groups, which would be better expressed with risk ratios. Odds ratios are not analogous to risk ratios, particularly when the outcome in question occurs commonly. The authors state that "diuretic use was associated with a 68% (95% confidence interval [CI], 6%-164%) increase in in-hospital mortality and a 77% (95% CI, 14%-176%) increase in the odds of death or nonrecovery of renal function." This statement is misleading and suggests a much larger increased risk from diuretics than was actually observed. The risk of dying with or without diuretics is very high and the actual increase in risk of death associated with diuretics was more on the order of 20% to 25%.
Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal
Instructions
Comments are moderated and will appear on the site at the discretion of the Journal of American Medical Association editors. Comments should not exceed 500 words of text and 10 references.
Do not submit personal medical questions or information that could identify a specific patient, questions about a particular case, or general inquiries to an author. Only content that has not been published, posted, or submitted elsewhere should be submitted. By submitting this Comment, you and any coauthors transfer copyright to the journal if your Comment is posted.
* = Required Field
Disclosure of Any Conflicts of Interest* Indicate all relevant conflicts of interest of each author below, including all relevant financial interests, activities, and relationships within the past 3 years including, but not limited to, employment, affiliation, grants or funding, consultancies, honoraria or payment, speakers’ bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued. If all authors have none, check "No potential conflicts or relevant financial interests" in the box below. Please also indicate any funding received in support of this work. The information will be posted with your response.
Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more
Subscribe for full-text access to content from 1998 forward and a host of useful features
Activate your current subscription (AMA members and current subscribers)
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Customize your page view by dragging & repositioning the boxes below.
and access these and other features:
Register Now
Enter your username and email address. We'll send you a reminder to the email address on record.
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.