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dc.contributor.authorZhan, M.
dc.contributor.authorSt., Peter, W.L.
dc.contributor.authorDoerfler, R.M.
dc.date.accessioned2019-07-26T15:58:31Z
dc.date.available2019-07-26T15:58:31Z
dc.date.issued2017
dc.identifier.urihttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85033396296&doi=10.2215%2fCJN.12311216&partnerID=40&md5=7e085e9074bef8573ceaff1df31f07b3
dc.identifier.urihttp://hdl.handle.net/10713/10124
dc.description.abstractBackground 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 into 15,917 visit-pairs (with an 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. Copyright 2017 by the American Society of Nephrology.en_US
dc.description.sponsorshipFunding for the Chronic Renal Insufficiency Cohort (CRIC) Study was obtained under a cooperative agreement from the NIDDK (grants U01DK060990, U01DK060984, U01DK061022, U01DK061021, U01DK061028, U01DK060980, U01DK060963, and U01DK060902).en_US
dc.description.urihttps://www.doi.org/10.2215/CJN.12311216en_US
dc.language.isoen_USen_US
dc.publisherAmerican Society of Nephrologyen_US
dc.relation.ispartofClinical Journal of the American Society of Nephrology
dc.subjectAnalgesicsen_US
dc.subjectChronic kidney diseaseen_US
dc.subjectNon-steroidal anti-inflammatory drugsen_US
dc.subjectOpioiden_US
dc.subjectSafetyen_US
dc.titlePatterns of NSAIDs use and their association with other analgesic use in CKDen_US
dc.typeArticleen_US
dc.identifier.doi10.2215/CJN.12311216
dc.identifier.pmid28811297


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