Association of analgesic use with prevalence of albuminuria and reduced GFR in US adults

Background: Prolonged analgesic consumption may adversely affect kidney function. The relation of long-term analgesic use to markers of decreased kidney function has not been investigated in the general population. Design: Cross-sectional analysis. Setting: National Health and Nutrition Examination Survey conducted in 1999-2002. Participants: Noninstitutionalized residents at least 20 years old (n = 8,057, representing 177.8 million adults). Predictors: Ever intake of an analgesic every day for at least a month defined habitual analgesic use, classified by product (aspirin, acetaminophen, ibuprofen, and selected prescription drugs) and years of use (< 1, 1 to 5, and > 5 years). Outcomes: Albuminuria in random urine (albumin-creatinine ratio >= 30 mg/g; n = 1,088) and reduced estimated glomerular filtration rate (eGFR; < 60 mL/min/1.73 m(2), n = 852) using the Modification of Diet in Renal Disease Study equation and the composite of either. Measurements: Age-standardized prevalence in habitual analgesic users and non-habitual analgesic users and multivariable-adjusted odds ratios (ORs). Results: In US adults, 23.7% (95% confidence interval [CI], 21.7 to 25.6) reported habitual analgesic use. Multivariable-adjusted ORs for reduced eGFR prevalence in adults with habitual analgesic use of acetaminophen only, ibuprofen only, and aspirin only were 1.03 (95% CI, 0.6 to 1.7),1.21 (95% CI, 0.7 to 2.1), and 0.95 (95% CI, 0.7 to 1.2) compared with non-habitual analgesic use, respectively, Corresponding ORs for prevalent albuminuria were 0.93 (95% CI, 0.7 to 1.3), 0.65 (95% CI, 0.4 to 1.2), and 0.86 (95% CI, 0.6 to 1.2). Association measures had intermediate levels for the composite marker of decreased kidney function and were not significant. No association between prevalent outcomes and habitual analgesic exposure duration of 5 years or longer or multiple product habitual analgesic consumption was observed. Limitations: Reliability of self-reported analgesic use behavior was not assessed. Conclusions: Habitual analgesic use of single or multiple products was not associated with increased prevalence of albuminuria or reduced eGFR.