AJM onlineClinical research studyNSAID Use and Progression of Chronic Kidney Disease
Section snippets
Study Population
The Conjoint Ethics Review Board at the University of Calgary approved this study. A cohort of elderly subjects aged ≥66 years were identified from the Calgary Laboratory Services database in Calgary, Alberta, Canada. This laboratory provides testing for the entire Calgary Health Region (catchment population 1.1 million) using a single regional laboratory and standardized methods that are recalibrated routinely against reference samples. To be eligible for inclusion in this study, participants
Results
There were 12,641 subjects ≥66 years of age identified who had at least 1 outpatient measurement of serum creatinine in each of the 2 defined time periods. As outlined in Figure 1, a total of 2545 patients were excluded as they did not meet the inclusion criterion, for a final study cohort of 10,184.
Baseline subject characteristics by type of NSAID are shown in Table 1. Baseline subject characteristics varied by type of NSAID, with traditional NSAID users tending to be younger, male, and have a
Discussion
In this prospective community-based study of over 10,000 elderly subjects a small, but statistically significant, increased risk of rapid progression of chronic kidney disease was found only among subjects with a baseline mean glomerular filtration rate between 60 and 89 mL/min/1.73 m2 who were exposed to nonselective NSAIDs only or to COX-2 inhibitors only. NSAID use was not associated with an increased risk of rapid progression of chronic kidney disease for subjects with lower levels of
References (24)
- et al.
Prevalence of chronic kidney disease and decreased kidney function in the adult US population: Third National Health and Nutrition Examination Survey
Am J Kidney Dis
(2003) - et al.
Non-steroidal anti-inflammatory drugs and renal failure
Lancet
(1986) - et al.
Chronic renal disease and papillary necrosis associated with the long-term use of nonsteroidal anti-inflammatory drugs as the sole or predominant analgesic
Am J Kidney Dis
(1994) - et al.
Analgesic use and change in kidney function in apparently healthy men
Am J Kidney Dis
(2003) - et al.
Prevalence of NSAID use among Alberta seniors in 2002-2003
Annals Epidemiol
(2004) - et al.
Nonsteroidal anti-inflammatory drugs and risk of ARF in the general population
Am J Kidney Dis
(2005) Excerpts from the USRDS 2004 Annual Report
Am J Kidney Dis
(2005)- 2001 Report, Volume 1: Dialysis and Renal Transplantation, Canadian Organ Replacement Register, Canadian Institute for...
K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification
Am J Kidney Dis
(2002)- et al.
Prevalence of kidney damage in Australian adults: the AusDiab kidney study
J Am Soc Nephrol
(2003)
Prevalence of low glomerular filtration rate in nondiabetic Americans: Third National Health and Nutrition Examination Survey (NHANES III)
J Am Soc Nephrol
Prevalence and correlates of elevated serum creatinine levels: the Framingham Heart Study
Arch Intern Med
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2022, European Journal of Internal MedicineCitation Excerpt :In a community study, NSAIDs users have a higher odds of developing CKD with OR of 1.63 (95% CI 1.22–2.19) [32]. They are also at increased risk of CKD progression, particularly among high dose users, with the pooled OR 1.26 (95% CI 1.06–1.50) [94,95]. The risk appears to be especially heightened among those with history of hypertension and diabetes [96,97].
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Supported by The Kidney Foundation of Canada and Alberta Improvements for Musculoskeletal Disorders Study.