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

被引:21
作者
Zhan, Min
St Peter, Wendy L.
Doerfler, Rebecca M.
Woods, Corinne M.
Blumenthal, Jacob B.
Diamantidis, Clarissa J. [2 ]
Hsu, Chi-yuan
Lash, James P.
Lustigova, Eva
Mahone, Erin B.
Ojo, Akinlolu O. [3 ]
Slaven, Anne
Strauss, Louise
Taliercio, Jonathan J.
Winkelmayer, Wolfgang C.
Xie, Dawei
Fink, Jeffery C. [1 ]
机构
[1] Univ Maryland, Sch Med, Dept Med, Room N3e03,22 South Greene St, Baltimore, MD 21201 USA
[2] Duke Univ, Sch Med, Dept Med, Durham, NC 27706 USA
[3] Univ Arizona, Dept Med, Tucson, AZ USA
来源
CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY | 2017年 / 12卷 / 11期
基金
美国国家卫生研究院;
关键词
CHRONIC KIDNEY-DISEASE; NONSTEROIDAL ANTIINFLAMMATORY DRUGS; RENAL-FUNCTION; OPIOID USE; PAIN; PROGRESSION; DECLINE;
D O I
10.2215/CJN.12311216
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
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 into15,917visit-pairs (withan 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 m(2) 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.
引用
收藏
页码:1778 / 1786
页数:9
相关论文
共 33 条
[1]   Cause for concern in the use of non-steroidal anti-inflammatory medications in the community -a population-based study [J].
Adams, Robert J. ;
Appleton, Sarah L. ;
Gill, Tiffany K. ;
Taylor, Anne W. ;
Wilson, David H. ;
Hill, Catherine L. .
BMC FAMILY PRACTICE, 2011, 12
[2]  
[Anonymous], NAT PAIN EXPR SCRIPT
[3]  
[Anonymous], AHFS DRUG INFORM
[4]  
[Anonymous], DRUG FACTS COMP
[5]  
[Anonymous], MICR HEALTHC SER
[6]   DRUG PRESCRIBING IN RENAL-FAILURE - DOSING GUIDELINES FOR ADULTS [J].
BENNETT, WM ;
ARONOFF, GR ;
MORRISON, G ;
GOLPER, TA ;
PULLIAM, J ;
WOLFSON, M ;
SINGER, I .
AMERICAN JOURNAL OF KIDNEY DISEASES, 1983, 3 (03) :155-193
[7]   Opioid Use in the US Hemodialysis Population [J].
Butler, Anne M. ;
Kshirsagar, Abhijit V. ;
Brookhart, M. Alan .
AMERICAN JOURNAL OF KIDNEY DISEASES, 2014, 63 (01) :171-173
[8]   Lifetime nonnarcotic analgesic use and decline in renal function in women [J].
Curhan, GC ;
Knight, EL ;
Rosner, B ;
Hankinson, SE ;
Stampfer, MJ .
ARCHIVES OF INTERNAL MEDICINE, 2004, 164 (14) :1519-1524
[9]  
Daubresse M, 2013, MED CARE, V51, P870, DOI 10.1097/MLR.0b013e3182a95d86
[10]   Dosing Errors in Prescribed Antibiotics for Older Persons With CKD: A Retrospective Time Series Analysis [J].
Farag, Alexandra ;
Garg, Amit X. ;
Li, Lihua ;
Jain, Arsh K. .
AMERICAN JOURNAL OF KIDNEY DISEASES, 2014, 63 (03) :422-428