The use of over-the-counter analgesics in patients with chronic kidney disease

Abstract

Background: Analgesics can be sold following medical prescription, but also as over-the-counter (OTC) medications. In patients with chronic kidney disease (CKD), their use could potentially be associated with increased risk of side-effects, due to impaired renal elimination. The aim was to evaluate the epidemiology and indications for the use of OTC analgesics, and the knowledge of their side-effects in patients with CKD. Materials and methods: A cross-sectional, controlled survey on the use of OTC analgesic drugs was conducted among 180 CKD patients (stage 1-5, dialysis, kidney transplant), compared to 60 controls. Results: The proportion of patients using OTC analgesics on a regular basis was higher in the CKD group, compared to controls (18.9% vs. 10.0%, p<0.02). The major indications included musculoskeletal issues, followed by headaches and other. Subgroup analysis revealed that analgesic use was lowest among transplanted patients, in comparison to CKD stage 1-5, and dialysis subjects (10%, 20%, 26%, respectively, p=0.06). Less than half of CKD patients and controls declared any knowledge on potential side-effects of analgesic drugs (45.6% vs. 40.0%, NS). Conclusions: The use of OTC analgesics among patients with CKD is higher than in subjects without CKD, with the exception of transplanted patients. The knowledge on the potential side-effect of analgesics is limited.

Analgesic use and associated adverse events in patients with chronic kidney disease: a systematic review and meta-analysis

“…Conversely, one study only assessed over-the-counter NSAID use. 48 Univariable meta-regression only found evidence for an association between prevalence of overall NSAID use and both percentage of patients of black ethnicity (negative association, P¼0.004, R 2 ¼50%) and percentage of patients of white ethnicity (positive association, P¼0.04, R 2 ¼32%). Bubble plots illustrate those relationships (Fig.…”