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Patterns of NSAIDs Use and Their Association with Other Analgesic Use in CKD.

Publication ,  Journal Article
Zhan, M; St Peter, WL; Doerfler, RM; Woods, CM; Blumenthal, JB; Diamantidis, CJ; Hsu, C-Y; Lash, JP; Lustigova, E; Mahone, EB; Ojo, AO; Xie, D ...
Published in: Clin J Am Soc Nephrol
November 7, 2017

BACKGROUND AND OBJECTIVES: Avoiding nonsteroidal anti-inflammatory drugs is important for safe CKD care. This study examined nonsteroidal anti-inflammatory drug use patterns and their association with other analgesic use in CKD. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: The Chronic Renal Insufficiency Cohort Study is an observational cohort study that enrolled 3939 adults ages 21-74 years old with CKD between 2003 and 2008 using age-based eGFR inclusion criteria. Annual visits between June of 2003 and December of 2011 were organized into 15,917 visit-pairs (with an antecedent and subsequent visit) for 3872 participants with medication information. Demographics, kidney function, and clinical factors were ascertained along with report of nonsteroidal anti-inflammatory drug or other analgesic use in the prior 30 days. RESULTS: In our study, 24% of participants reported nonsteroidal anti-inflammatory drug use at baseline or at least one follow-up study visit. Having a 10 ml/min per 1.73 m2 higher eGFR level at an antecedent visit was associated with higher odds of starting nonsteroidal anti-inflammatory drugs at a subsequent visit (odds ratio, 1.44; 95% confidence interval, 1.34 to 1.56). Seeing a nephrologist at the antecedent visit was associated with lower odds of starting or staying on nonsteroidal anti-inflammatory drugs at a subsequent visit (odds ratio, 0.70; 95% confidence interval, 0.56 to 0.87 and odds ratio, 0.61; 95% confidence interval, 0.46 to 0.81, respectively). Starting and stopping nonsteroidal anti-inflammatory drugs were both associated with higher odds of increasing the number of other analgesics (odds ratio, 1.52; 95% confidence interval, 1.25 to 1.85 and odds ratio, 1.78; 95% confidence interval, 1.39 to 2.28, respectively) and higher odds of increasing the number of opioid analgesics specifically (odds ratio, 1.92; 95% confidence interval, 1.48 to 2.48 and odds ratio, 1.46; 95% confidence interval, 1.04 to 2.03, respectively). CONCLUSIONS: Nonsteroidal anti-inflammatory drug use is common among patients with CKD but less so among those with worse kidney function or those who see a nephrologist. Initiation or discontinuation of nonsteroidal anti-inflammatory drugs is often associated with supplementation with or replacement by, respectively, other analgesics, including opioids, which introduces possible drug-related problems when taking these alternative analgesics.

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Published In

Clin J Am Soc Nephrol

DOI

EISSN

1555-905X

Publication Date

November 7, 2017

Volume

12

Issue

11

Start / End Page

1778 / 1786

Location

United States

Related Subject Headings

  • Young Adult
  • Urology & Nephrology
  • Self Report
  • Self Medication
  • Retrospective Studies
  • Renal Insufficiency, Chronic
  • Office Visits
  • Nephrology
  • Middle Aged
  • Male
 

Citation

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Zhan, M., St Peter, W. L., Doerfler, R. M., Woods, C. M., Blumenthal, J. B., Diamantidis, C. J., … Chronic Renal Insufficiency Cohort (CRIC) Study Investigators, . (2017). Patterns of NSAIDs Use and Their Association with Other Analgesic Use in CKD. Clin J Am Soc Nephrol, 12(11), 1778–1786. https://doi.org/10.2215/CJN.12311216
Zhan, Min, Wendy L. St Peter, Rebecca M. Doerfler, Corinne M. Woods, Jacob B. Blumenthal, Clarissa J. Diamantidis, Chi-Yuan Hsu, et al. “Patterns of NSAIDs Use and Their Association with Other Analgesic Use in CKD.Clin J Am Soc Nephrol 12, no. 11 (November 7, 2017): 1778–86. https://doi.org/10.2215/CJN.12311216.
Zhan M, St Peter WL, Doerfler RM, Woods CM, Blumenthal JB, Diamantidis CJ, et al. Patterns of NSAIDs Use and Their Association with Other Analgesic Use in CKD. Clin J Am Soc Nephrol. 2017 Nov 7;12(11):1778–86.
Zhan, Min, et al. “Patterns of NSAIDs Use and Their Association with Other Analgesic Use in CKD.Clin J Am Soc Nephrol, vol. 12, no. 11, Nov. 2017, pp. 1778–86. Pubmed, doi:10.2215/CJN.12311216.
Zhan M, St Peter WL, Doerfler RM, Woods CM, Blumenthal JB, Diamantidis CJ, Hsu C-Y, Lash JP, Lustigova E, Mahone EB, Ojo AO, Slaven A, Strauss L, Taliercio JJ, Winkelmayer WC, Xie D, Fink JC, Chronic Renal Insufficiency Cohort (CRIC) Study Investigators. Patterns of NSAIDs Use and Their Association with Other Analgesic Use in CKD. Clin J Am Soc Nephrol. 2017 Nov 7;12(11):1778–1786.

Published In

Clin J Am Soc Nephrol

DOI

EISSN

1555-905X

Publication Date

November 7, 2017

Volume

12

Issue

11

Start / End Page

1778 / 1786

Location

United States

Related Subject Headings

  • Young Adult
  • Urology & Nephrology
  • Self Report
  • Self Medication
  • Retrospective Studies
  • Renal Insufficiency, Chronic
  • Office Visits
  • Nephrology
  • Middle Aged
  • Male