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Influence of creatinine versus glomerular filtration rate on non-steroidal anti-inflammatory drug prescriptions in chronic kidney disease.

Publication ,  Journal Article
Patel, K; Diamantidis, C; Zhan, M; Hsu, VD; Walker, LD; Gardner, J; Weir, MR; Fink, JC
Published in: Am J Nephrol
2012

BACKGROUND: Non-steroidal anti-inflammatory drugs (NSAIDs), including cyclooxygenase-2 (COX-2) inhibitors, are generally contraindicated in chronic kidney disease (CKD). This investigation sought to identify the frequency of NSAID/COX-2 prescription and to determine the influence of serum creatinine (Cr) versus estimated glomerular filtration rate (eGFR) on this practice pattern. METHODS: An established Veterans Health Administration CKD safety cohort (n = 70,154) was examined to determine the frequency of NSAID/COX-2 in fiscal year 2005 (FY05) for up to 30 days preceding the index hospitalization and as many as 365 days during that year. Binomial regression was used to determine adjusted prevalence ratios for prescription of NSAID/COX-2 with respect to continuous eGFR measurement and serum Cr categories. CKD was defined as eGFR <60 ml/min/1.73 m(2). RESULTS: 15.4% of the subjects had an NSAID/COX-2 prescription during the observation period. The proportion of these prescribed agents decreased with declining renal function, but remained significant at any stage of CKD given the renal harm related to these medications. At specific GFR estimates, serum Cr remained a significant predictor of NSAID/COX-2 prescription. At GFR set at 42 ml/min/1.73 m(2), the predicted proportion of prescribed NSAID/COX-2 was 0.29 (95% CI 0.24, 0.36), 0.23 (95% CI 0.22, 0.26), 0.20 (95% CI 0.19, 0.22), and 0.12 (95% CI 0.10, 0.14) for Cr strata of ≤1.3, 1.4-1.6, 1.7-2.1, and ≥2.2 mg/dl, respectively (all p < 0.05). CONCLUSION: A significant proportion of individuals with CKD continue to be prescribed NSAID/COX-2 and serum Cr remains an influential guide to NSAID/COX-2 prescription, even in GFR ranges where these agents are ill advised.

Duke Scholars

Published In

Am J Nephrol

DOI

EISSN

1421-9670

Publication Date

2012

Volume

36

Issue

1

Start / End Page

19 / 26

Location

Switzerland

Related Subject Headings

  • Urology & Nephrology
  • United States Department of Veterans Affairs
  • United States
  • Retrospective Studies
  • Renal Insufficiency, Chronic
  • Prevalence
  • Middle Aged
  • Male
  • Inflammation
  • Humans
 

Citation

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Patel, K., Diamantidis, C., Zhan, M., Hsu, V. D., Walker, L. D., Gardner, J., … Fink, J. C. (2012). Influence of creatinine versus glomerular filtration rate on non-steroidal anti-inflammatory drug prescriptions in chronic kidney disease. Am J Nephrol, 36(1), 19–26. https://doi.org/10.1159/000339439
Patel, Krupa, Clarissa Diamantidis, Min Zhan, Van Doren Hsu, Loreen D. Walker, James Gardner, Matthew R. Weir, and Jeffrey C. Fink. “Influence of creatinine versus glomerular filtration rate on non-steroidal anti-inflammatory drug prescriptions in chronic kidney disease.Am J Nephrol 36, no. 1 (2012): 19–26. https://doi.org/10.1159/000339439.
Patel K, Diamantidis C, Zhan M, Hsu VD, Walker LD, Gardner J, et al. Influence of creatinine versus glomerular filtration rate on non-steroidal anti-inflammatory drug prescriptions in chronic kidney disease. Am J Nephrol. 2012;36(1):19–26.
Patel, Krupa, et al. “Influence of creatinine versus glomerular filtration rate on non-steroidal anti-inflammatory drug prescriptions in chronic kidney disease.Am J Nephrol, vol. 36, no. 1, 2012, pp. 19–26. Pubmed, doi:10.1159/000339439.
Patel K, Diamantidis C, Zhan M, Hsu VD, Walker LD, Gardner J, Weir MR, Fink JC. Influence of creatinine versus glomerular filtration rate on non-steroidal anti-inflammatory drug prescriptions in chronic kidney disease. Am J Nephrol. 2012;36(1):19–26.
Journal cover image

Published In

Am J Nephrol

DOI

EISSN

1421-9670

Publication Date

2012

Volume

36

Issue

1

Start / End Page

19 / 26

Location

Switzerland

Related Subject Headings

  • Urology & Nephrology
  • United States Department of Veterans Affairs
  • United States
  • Retrospective Studies
  • Renal Insufficiency, Chronic
  • Prevalence
  • Middle Aged
  • Male
  • Inflammation
  • Humans