Analgesic use and the risk for progression of chronic kidney disease

Kuo, Hsin‐Wei; Tsai, Shang-Shyue; Tiao, Mao‐Meng; Liu, Yichun; Lee, I‐Ming; Yang, Chun‐Yuh

doi:10.1002/pds.1962

Cited by 75 publications

(61 citation statements)

References 29 publications

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“…However, short-and long-term effects of sCOX-2 inhibitors in the progression of chronic kidney disease (CKD) remain unclear. 4 The results from the large cohort study by Kuo et al 5 and Gooch et al 6 showed that the sCOX-2 inhibitors might increase the risk of end-stage renal disease, which was in contrast with the result from the systematic review in the following years that concluded no definite renal outcome in a long-term period. The current study was conducted to mainly determine the relationship between sCOX-2 inhibitors and renal progression among CKD patients in short-and long-term periods.…”

Section: Introductioncontrasting

confidence: 51%

“…Although high cumulative NSAID exposure was significantly associated with an increased risk of accelerated CKD progression, regular NSAID use was not associated with an increased risk of accelerated CKD progression, especially among Stage 3 CKD patients. According to Kuo et al, 5 CKD patients using NSAIDs had an increased risk for ESRD. In contrast, Evans et al 13 reported no significant association between aspirin use and renal function decline.…”

Section: Discussionmentioning

confidence: 99%

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Selective cyclooxygenase-2 inhibitor use and progression of renal function in patients with chronic kidney disease: a single-center retrospective cohort study

Kaewput

Disorn

Satirapoj

2016

IJNRD

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Background:The use of selective COX-2 (sCOX-2) inhibitors with acute kidney injury, salt water retention, and cardiovascular events have been correlated in subjects with normal kidney function, but sCOX-2 inhibitor use concerning the progression of chronic kidney disease (CKD) remains uncertain. Objectives: To determine the progression of renal function and electrolyte abnormalities among CKD patients after using sCOX-2 inhibitors during short-and long-term periods. Methods: The study employed a retrospective cohort design comprising all types of CKD patients with and without sCOX-2 inhibitors (celecoxib and etoricoxib). Data collected included medical data, estimated glomerular filtration rate (eGFR), and serum electrolytes at 3 and 6 months between January 2009 and January 2014. Subjects attended the outpatient clinic and were then followed up until discontinuation of the drugs at years 1 and 2 until May 2016. Results: Ninety-two CKD patients on sCOX-2 inhibitors and 92 CKD patients without sCOX-2 inhibitors were included. The sCOX-2 inhibitor group showed more decline in eGFR than the control group at 3 and 6 months of follow-up (-8 , P=0.005, respectively). In addition, the sCOX-2 inhibitor group had significantly more increased serum potassium during the study follow-up than the control group. Conclusion: The sCOX-2 inhibitors are associated with an increased risk for rapid eGFR decline and hyperkalemia in both the short term and in the long term after sCOX-2 inhibitors were terminated in the setting of a community-based CKD population. For CKD patients, these results suggest that sCOX-2 inhibitors should be closely monitored and chronic exposure to any sCOX-2 inhibitors should be avoided.

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Section: Introductioncontrasting

confidence: 51%

Section: Discussionmentioning

confidence: 99%

Selective cyclooxygenase-2 inhibitor use and progression of renal function in patients with chronic kidney disease: a single-center retrospective cohort study

Kaewput

Disorn

Satirapoj

2016

IJNRD

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“…Considering these drugs used for self-medication, the use of non-steroidal anti-inflammatory drugs (NSAID) stands out. NSAIDs show considerable potential for drug interactions (Micromedex, 2011) and adverse reactions, such as an increase in cardiovascular risk (Hudson, Richard, Pilote, 2005) and increases in renal dysfunction in patients with chronic kidney disease, a condition that tends to occur with greater incidence in elderly patients (Kuo et al, 2010). Apart from the NSAIDs, the use of carisoprodol should also be highlighted, since this drug is considered inappropriate for the elderly, on account of it showing a high risk of causing anticholinergic adverse effects, sedation, weakness and risk of fractures (American Geriatrics Society, 2012).…”

Section: Discussionmentioning

confidence: 99%

Pharmacoepidemiological profile and polypharmacy indicators in elderly outpatients

Baldoni

Ayres

Martinez

et al. 2013

Braz. J. Pharm. Sci.

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This cross-sectional study was carried out with 1000 elderly outpatients assisted by a Basic Health District Unit (UBDS) from the Brazilian Public Health System (SUS) in the municipality of Ribeirão Preto. We analyzed the clinical, socioeconomic and pharmacoepidemiological profile of the elderly patients in order to identify factors associated with polypharmacy amongst this population. We used a truncated negative binomial model to examine the association of polypharmacy with the independent variables of the study. The software SAS was used for the statistical analysis and the significance level adopted was 0.05. The most prevalent drugs were those for the cardiovascular system (83.4%). There was a mean use of seven drugs per patient and 47.9% of the interviewees used ≥7 drugs. The variables that showed association with polypharmacy (P value < 0.01) were female gender, age >75 years, self-medication, number of health problems, number of medical appointments, presence of adverse drug events, use of over-the-counter drugs, use of psychotropic drugs, lack of physical exercise and use of sweeteners. The exposition to all these factors justified the high prevalence of polypharmacy amongst the interviewees. These results showed the need to adopt clinical intervention and educational and managerial measures to analyze and promote rationality in the use of drugs amongst the elderly users of SUS. Uniterms:Pharmacoepidemiology. Elderly/use of drugs. Polypharmacy. Drugs/rational use. Public Health System. Este estudo transversal foi realizado por meio de entrevistas com 1000 idosos atendidos em uma Unidade Básica Distrital de Saúde (UBDS) do Sistema Único de Saúde (SUS) no município de Ribeirão Preto. Analisou-se o perfil clínico, socioeconômico e farmacoepidemiológico a fim de identificar os fatores associados à polifarmácia nessa população. Utilizou-se um modelo binomial negativo truncado para análise da associação da polifarmácia com as variáveis independentes do estudo. O software SAS foi utilizado para a análise estatística. O nível de significância adotado foi de 0,05. Os fármacos com maior prevalência de uso foram do sistema cardiovascular (83,4%). Observou-se média de, aproximadamente, sete fármacos por paciente e 47,9% dos entrevistados usavam >7 fármacos. As variáveis que apresentaram associação com a polifarmácia (p< 0,01) foram: mulheres, idade (>75 anos), automedicação, quantidade de problemas de saúde, número de consultas médicas, uso de medicamentos isentos de prescrição médica, uso de psicotrópicos, não realização de exercícios físicos e uso de adoçante. A exposição a todos esses fatores justifica a alta prevalência de polifarmácia entre os entrevistados. Os resultados mostraram a necessidade de adotar medidas de intervenção clínica e educacional e gerencial para analisar e promover a racionalização do uso de fármacos entre os idosos usuários do SUS.Unitermos: Farmacoepidemiologia. Idoso/uso de medicamentos. Polifarmácia. Medicamentos/uso racional. Sistema Público de Saúde.

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“…3 However, the presence of those co-morbid conditions did not fully explain the risks of CKD in Taiwan, suggesting that other potential risks in Taiwan needed to be explored, including use of analgesics, family history (either genetic susceptibility or environmental factors), and other non-biomedical factors, such as caffeine and alcohol intake, smoking, bet-nut use, and socioeconomic status. [9][10][11][12] Musculoskeletal pain was much more prevalent in CKD patients (72.9%) compared with non-CKD patients (9%). 13 That illness might lead to more analgesics use, including acetaminophen, nonsteroidal anti-inflammatory drugs, narcotics, or even combination therapy.…”

Section: Introductionmentioning

confidence: 99%

Analgesic use, parents’ clan, and coffee intake are three independent risk factors of chronic kidney disease in middle and elderly-aged population: a community-based study

et al. 2014

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(2014) Analgesic use, parents' clan, and coffee intake are three independent risk factors of chronic kidney disease in middle and elderly-aged population: a community-based study, Renal Failure, 36:3,[361][362][363][364][365][366] DOI: 10.3109 A questionnaire was administered to study participants, collecting information on ethnicity, use of analgesics, and life habits. Age, sex, and blood biochemical analyses were considered as potential confounders. A high prevalence and low awareness of CKD were noted in this population. Females with CKD had a lower awareness of their illness than males. Analgesic users had a significantly lower estimated glomerular filtration rate (eGFR). Age (OR ¼ 1.095), females (OR ¼ 0.348), fasting plasma glucose (OR ¼ 1.005), level of uric acid (UA) (OR ¼ 1.517), and analgesic usage (OR ¼ 1.512) remained independent predictors of CKD. Multivariate linear regression found that use of analgesics, father' clan from Fujian, mother' clan from Fujian, and coffee intake were independent determinants of renal outcome with coefficient of regression (b) of À0.102, À0.192, 0.210 and 0.88, respectively. The prevalence of CKD decreased with advanced education. Further, there was no significant difference between education background and analgesics use. In conclusion, analgesic use, parents' clan, and coffee intake were independent risk factors for CKD in middle-aged and elderly Taiwanese. Thus, an effective educational program that increases the awareness of such individuals residing in rural counties is warranted.

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Analgesic use and the risk for progression of chronic kidney disease

Cited by 75 publications

References 29 publications

Selective cyclooxygenase-2 inhibitor use and progression of renal function in patients with chronic kidney disease: a single-center retrospective cohort study

Selective cyclooxygenase-2 inhibitor use and progression of renal function in patients with chronic kidney disease: a single-center retrospective cohort study

Pharmacoepidemiological profile and polypharmacy indicators in elderly outpatients

Analgesic use, parents’ clan, and coffee intake are three independent risk factors of chronic kidney disease in middle and elderly-aged population: a community-based study

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