Association of Individual Non-Steroidal Anti-Inflammatory Drugs and Chronic Kidney Disease: A Population-Based Case Control Study

被引:53
作者
Ingrasciotta, Ylenia [1 ]
Sultana, Janet [1 ]
Giorgianni, Francesco [1 ]
Fontana, Andrea [2 ]
Santangelo, Antonio [1 ]
Tari, Daniele Ugo [3 ]
Santoro, Domenico [1 ]
Arcoraci, Vincenzo [1 ]
Perrotta, Margherita [3 ]
Ibanez, Luisa [4 ]
Trifiro, Gianluca [1 ]
机构
[1] Univ Messina, Dept Clin & Expt Med, Messina, Italy
[2] IRCCS Casa Sollievo Sofferenza, Biostat Unit, San Giovanni Rotondo, FG, Italy
[3] Caserta Local Hlth Serv, Caserta, Italy
[4] Univ Autonoma Barcelona, WHO Collaborating Ctr Res & Training Pharmacoepid, Dept Pharmacol Toxicol & Therapeut, Fdn Inst Catala Farmacol,Inst Catala Salut, E-08193 Barcelona, Spain
来源
PLOS ONE | 2015年 / 10卷 / 04期
关键词
CHRONIC RENAL-DISEASE; ANALGESIC USE; PRESCRIBING PATTERN; GENERAL-PRACTICE; INTERACTION RISK; FAILURE; ACETAMINOPHEN; ASPIRIN; BURDEN; MEN;
D O I
10.1371/journal.pone.0122899
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Background Non-steroidal anti-inflammatory agents (NSAIDs) are known to be associated with renal damage. No clear evidence exists regarding differential risk of chronic kidney disease (CKD), specifically, across various NSAIDs. Aim The aim of this population-based case-control study was to evaluate the association between use of individual NSAIDs and risk of CKD in a general population of Southern Italy. Methods A nested case-control study was carried out using the general practice Arianna database, identifying incident CKD patients as cases and matched controls from 2006 to 2011. The date of first CKD diagnosis was defined as the index date (ID). Conditional logistic regressions were performed to estimate the risk of CKD associated with NSAIDs by class and individual drugs as compared to non-use during different time windows (within one year, six or three months prior to ID), with the latter being defined as current users. Among current users, the effect of cumulative exposure to these drugs was evaluated. Results Overall, 1,989 CKD cases and 7,906 matched controls were identified. A statistically significant increase in the risk of CKD was found for current users of oxicams (adjusted OR: 1.68; 95% CI: 1.15-2.44) and concerning individual compounds, for ketorolac (adj. OR: 2.54; 95% CI: 1.45-4.44), meloxicam (adj. OR: 1.98; 95% CI: 1.01-3.87) and piroxicam (adj. OR: 1.95; 95% CI: 1.19-3.21). Conclusions The risk of CKD varies across individual NSAIDs. Increased risk has been found for ketorolac, which may precipitate subclinical CKD through acute renal damage, and long-term exposure to oxicams, especially meloxicam and piroxicam.
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页数:14
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