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Use of nonsteroidal anti-inflammatory drugs linked to increased risk of end-stage renal disease requiring chronic dialysis


It is known that many medical adverse events can be caused by nonsteroidal anti-inflammatory drugs ( NSAIDs ); however, epidemiologic evidence has not granted an affirmative relationship between NSAID use and the risk of end-stage renal disease ( ESRD ).

Researchers have investigated the relationship in a Chinese population between short-term NSAID use and development of ESRD requiring chronic dialysis.

A retrospective case-crossover design was used in this study.

Using the Taiwanese National Health Insurance database, researchers identified 109,400 incident chronic ESRD patients with dialysis initiation from 1998 to 2009.

For each patient, researchers defined the case period as 1 to 14 days and the control period as 105 to 118 days, respectively, before the first dialysis date.
The washout period was 90 days between the case and control period.
Detailed information about NSAID use was compared between the case and control periods.

NSAID use was found to be a significant risk factor associated with dialysis commencement.

The adjusted odds ratio ( OR ) was 2.73 ( 95% CI: 2.62-2.84 ) for nonselective NSAIDs and 2.17 ( 95% CI: 1.83-2.57 ) for Celecoxib [ Celebrex ].

The odds ratio reached 3.05 for the use of acetic acid derivatives.

Compared with the oral forms, significantly higher risks were seen in parenteral NSAID use ( OR=8.66, 95% CI: 6.12-20.19 ).

Conclusion: NSAIDs should be prescribed with caution, especially for those in ESRD high-risk groups. ( Xagena )

Chang YK et al, Medicine 2015;94:e1362

XagenaMedicine_2015



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