Association of Nonsteroidal Anti-inflammatory Drug Prescriptions With Kidney Disease Among Active Young and Middle-aged Adults

Nelson, Douglas A.; Marks, Eric S; Deuster, Patricia A.; O’Connor, Francis G.; Kurina, Lianne M.

doi:10.1001/jamanetworkopen.2018.7896

Cited by 57 publications

(38 citation statements)

References 41 publications

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“…Because we do not have genetic data in our database, we are unable to control for population substructure. However, the magnitude of the SCT effect we observed in this study is approximately as large as the entire difference between African American soldiers and white soldiers in our dataset (Nelson et al , ), so a small shift in ancestry proportions would not be enough to drive the entire observed effect.…”

Section: Discussioncontrasting

confidence: 60%

Sickle cell trait and renal disease among African American U.S. Army soldiers

Nelson

Deuster

et al. 2019

Br J Haematol

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Sickle cell trait and certain renal disorders are disproportionately prevalent among African American individuals, so a clear understanding of their association is important. We conducted a longitudinal study using the Stanford Military Data Repository to examine sickle cell trait in relation to the incidence of acute kidney injury (AKI) and chronic kidney disease (CKD). Our study population consisted of African American U.S. Army soldiers on active duty between January 2011 and December 2014. The cumulative incidence was 0Á51% for AKI (236 cases out of 45 901 soldiers) and 0Á56% for CKD (255 cases out of 45 882 soldiers). Discrete time logistic regression models adjusting for demographic-, military-and healthcare-related covariates showed that sickle cell trait was associated with significantly higher adjusted odds of both AKI [odds ratio (OR): 1Á74; 95% confidence interval (CI): 1Á17-2Á59] and CKD (OR: 2Á00; 95% CI: 1Á39-2Á88). Elevated odds of AKI and CKD were also observed in association with prior CKD and AKI, respectively, and with obesity and prior hypertension. Individuals with sickle cell trait and their providers should be aware of the possibility of increased risk of AKI and CKD to allow for timely intervention and possible prevention.

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Section: Discussioncontrasting

confidence: 60%

Sickle cell trait and renal disease among African American U.S. Army soldiers

Nelson

Deuster

et al. 2019

Br J Haematol

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“…86 A retrospective longitudinal cohort study of US Army soldiers without pre-existing kidney disease demonstrated 20% greater risk for CKD progression among patients receiving more than 7 World Health Organization-defined daily doses per month of total NSAIDs compared with nonusers. 87 Similarly, a casecontrol study found an association between stage 5 CKD development and NSAIDs only in users of the highest quantities. 79 In summary, although the risk for CKD progression due to NSAID use is not insignificant, it appears to be small, related to cumulative dose, and modifiable by appropriate patient selection in patients with mild to moderate CKD.…”

Section: Hypertensionmentioning

confidence: 96%

NSAIDs in CKD: Are They Safe?

Baker

Perazella

2020

American Journal of Kidney Diseases

150

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The management of pain in patients with chronic kidney disease (CKD) is challenging for many reasons. These patients have increased susceptibility to adverse drug effects due to altered drug metabolism and excretion, and there are limited safety data for use in this population despite a high pain burden. Nonsteroidal anti-inflammatory drugs (NSAIDs) have long been regarded as dangerous for use in patients with CKD because of their risk for nephrotoxicity and thus alternative classes of analgesics, including opioids, have become more commonly used for pain control in this population. Given the well-established risks that opioids and other analgesics pose, further characterization of the risk posed by NSAIDs in patients with CKD is warranted. NSAID use has been associated with acute kidney injury, progressive loss of glomerular filtration rate in CKD, electrolyte derangements, and hypervolemia with worsening of heart failure and hypertension. The risk for these nephrotoxicity syndromes is modified by many comorbid conditions, risk factors, and characteristics of use, and in patients with CKD, the risk differs between levels of glomerular filtration rate. In this review, we offer recommendations for the cautious use of NSAIDs in the CKD population after careful consideration of these risk factors on an individualized basis. Complete author and article information provided before references.

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“…A self-reported study of over-the-counter and prescribed use of ibuprofen, which falls into the class of NSAIDs, noted that 90% took it regularly. In comparison, 37% took other forms of NSAIDs in addition to ibuprofen, and 11% exceeded the daily recommended limit of ibuprofen [2]. This case report emphasizes the importance of public awareness regarding analgesics and its associated side effects with large doses.…”

Section: Introductionmentioning

confidence: 83%

Lack of Patient Knowledge Regarding the Adverse Effects of Analgesics With High Doses Leading to Elevation of Creatinine and Major Consequences – A Case Report

Challa

Arja

Ponduchi

et al. 2020

Cureus

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We present a case of a 49-year-old male with complaints of back pain and not being able to urinate. The patient was suffering from back pain for the last four days and followed up with the chiropractor, but the pain persisted. The patient took eight ibuprofen tablets (1600 mg) within those four days to relieve the pain. Lab workup showed a blood urea nitrogen (BUN) of 175 mg/dL, creatinine level of 32.87mg/dL, and an anion gap metabolic acidosis. With close monitoring and dialysis in the hospital, the creatinine came down to 11.92mg/dL. Ultrasound-guided renal biopsy showed that the patient developed acute interstitial nephritis. The patient was treated with prednisone and later discharged with a creatinine level of 8.60mg/dL. Before he was discharged, he was declared to have end-stage renal disease and placed on outpatient dialysis. Only a few case reports are recorded in the literature with such a high elevation of creatinine levels.

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Association of Nonsteroidal Anti-inflammatory Drug Prescriptions With Kidney Disease Among Active Young and Middle-aged Adults

Cited by 57 publications

References 41 publications

Sickle cell trait and renal disease among African American U.S. Army soldiers

Sickle cell trait and renal disease among African American U.S. Army soldiers

NSAIDs in CKD: Are They Safe?

Lack of Patient Knowledge Regarding the Adverse Effects of Analgesics With High Doses Leading to Elevation of Creatinine and Major Consequences – A Case Report

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