Use of Nonsteroidal Anti-Inflammatory Drugs and Risk of Chronic Kidney Disease in Subjects With Hypertension

Abstract

Abstract-Limited studies have examined the effects of nonsteroidal anti-inflammatory drug (NSAID) use on the risk of chronic kidney disease (CKD), especially in subjects with hypertension. Using National Health Insurance claims data in Taiwan, we conducted a propensity score-matched cohort study to investigate the relationship between NSAID use and CKD in subjects with hypertension. A total of 31 976 subjects were included in this study: subjects not taking any NSAIDs in 2007 (n=10 782); subjects taking NSAIDs for 1 to 89 days in 2007 (n=10 605); and subjects taking NSAIDs for ≥90 days in 2007 (n=10 589). We performed multivariable proportional hazard models to determine the relationship between NSAID use and CKD. The results showed that NSAID use was associated with a 1.18-fold increased risk of CKD in subjects taking NSAIDs for 1 to 89 days; and a 1.32-fold increased risk of CKD in hypertension subjects taking NSAIDs for ≥90 days, compared with subjects not taking any NSAIDs, after controlling for the confounding factors. In subgroup analyses, subjects taking NSAIDs for ≥90 days, >1 defined daily dose per day or taking NSAIDs >15 cumulative defined daily doses had a greater risk of CKD than subjects not taking any NSAID, but not for congestive heart failure, stroke, cancer, osteoarthritis, or rheumatoid arthritis. These results provide supportive evidence that NSAID use is associated with increased risk of CKD in subjects with hypertension. It is important to closely monitor the effects of NSAID use, particularly in patients with hypertension, a susceptible population for CKD.

Treatment of Elderly Patients With Dorsopathy

“…Пожилой и старческий возраст -фактор риска раз-вития и других острых или обострения имеющихся хро-нических соматических заболеваний, причем по мере старения больного все факторы приобретают большую значимость, а совокупность их является критической в отношении развития поражения почек, повышении артериального давления, гепатопатии и целого ряда других заболеваний [12,13]. Ситуация осложняется необходимостью приема ряда других препаратов и высокого риска лекарственных взаимодействий [14].…”

Short-Term Non-Steroid Anti-Inflammatory Drug Use in Spondyloarthritis Patients Induces Subclinical Acute Kidney Injury: Biomarkers Study

“…Minimal NSAID exposure was defined as <7 tablets in last week and <15 tablets in last month and <2 tablets/week in last year and <1,000 tablets lifetime exposure including acetaminophen and aspirin tablets [6,7,8,9]. …”

“…Frequent NSAID use (>2 tablets/week for 1 year) or lifetime exposure of >1,000 tablets has been associated with 1.4-8.8-fold higher risk of end-stage renal disease (ESRD) [6,7,8]. On the contrary, it has been shown that total NSAID intakes of 2,500 or more tablets are not associated with rise in serum creatinine (sCr) or its clearance [9].…”

“…A study evaluating 4-year declining trend of estimated glomerular filtration rate (eGFR) using Cockcroft-Gault equation (eGFR CG ) showed that NSAID use was an independent predictor for accelerated decline only in patients with baseline eGFR CG <30 mL/min [10]. Thus, the NSAID use among patients without pre-existing kidney dysfunction have minimal risk if any for developing ESRD [6,7,8,9,10,11,12]. But sCr measurement is insensitive and detects advanced kidney injury when it is often irreversible.…”

Use of Nonsteroidal Anti-Inflammatory Drugs for the Treatment of Axial Spondyloarthritis, Including Ankylosing Spondylitis, Monitoring Their Efficacy and Safety (Draft Guidelines of the Expert Spondyloarthritis Diagnosis and Treatment Group)

“…Изве-стно, что при ревматических заболеваниях имеется по-вышенный риск развития осложнений со стороны ЖКТ, ССС и почек, в том числе и вне зависимости от получаемого лечения [39][40][41][42][43][44][45][46][47]. Существующие на дан-ный момент шкалы не способны учитывать вклад вос-паления в повышение соответствующих рисков.…”