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High prevalence of non-steroidal anti-inflammatory drug use among acute kidney injury survivors in the southern community cohort study

BACKGROUND: Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used and have been linked to acute kidney injury (AKI), chronic kidney disease (CKD) and cardiovascular disease (CVD). Patients who survive an AKI episode are at risk for future adverse kidney and cardiovascular outcomes. The obje...

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Autores principales: Lipworth, Loren, Abdel-Kader, Khaled, Morse, Jennifer, Stewart, Thomas G., Kabagambe, Edmond K., Parr, Sharidan K., Birdwell, Kelly A., Matheny, Michael E., Hung, Adriana M., Blot, William J., Ikizler, T. Alp, Siew, Edward D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5122006/
https://www.ncbi.nlm.nih.gov/pubmed/27881100
http://dx.doi.org/10.1186/s12882-016-0411-7
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author Lipworth, Loren
Abdel-Kader, Khaled
Morse, Jennifer
Stewart, Thomas G.
Kabagambe, Edmond K.
Parr, Sharidan K.
Birdwell, Kelly A.
Matheny, Michael E.
Hung, Adriana M.
Blot, William J.
Ikizler, T. Alp
Siew, Edward D.
author_facet Lipworth, Loren
Abdel-Kader, Khaled
Morse, Jennifer
Stewart, Thomas G.
Kabagambe, Edmond K.
Parr, Sharidan K.
Birdwell, Kelly A.
Matheny, Michael E.
Hung, Adriana M.
Blot, William J.
Ikizler, T. Alp
Siew, Edward D.
author_sort Lipworth, Loren
collection PubMed
description BACKGROUND: Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used and have been linked to acute kidney injury (AKI), chronic kidney disease (CKD) and cardiovascular disease (CVD). Patients who survive an AKI episode are at risk for future adverse kidney and cardiovascular outcomes. The objective of our study was to examine the prevalence and predictors of NSAID use among AKI survivors. METHODS: The Southern Community Cohort Study is a prospective study of low-income adults aged 40–79 in the southeastern US. Through linkage with Centers for Medicare and Medicaid Services, 826 participants with an AKI diagnosis (ICD-9 584.5-584.9) at any age prior to cohort enrollment were identified. At baseline, data were collected on regular use of prescription and over-the-counter NSAIDs, as well as demographic, medical and other characteristics. Additional comorbidities were ascertained via linkage with CMS or the US Renal Data System. RESULTS: One hundred fifty-four AKI survivors (19%) reported regular NSAID use at cohort enrollment (52 prescription, 81 OTC, 21 both) and the percentage of NSAID users did not vary by time since AKI event. Over 58% of users were taking NSAIDS regularly both before and after their AKI event. Hypertension (83%), arthritis (71%), heart failure (44%), CKD (36%) and diabetes (35%) were prevalent among NSAID users. In a multivariable model, history of arthritis (OR: 3.00; 95% CI: 1.92, 4.68) and acetaminophen use (OR: 2.43; 95% CI: 1.50, 3.93) were significantly associated with NSAID use, while prevalent CKD (OR: 0.63; 95% CI: 0.41, 0.98) and diabetes (OR: 0.44; 95% CI: 0.29, 0.69) were significantly inversely associated. CONCLUSIONS: NSAID use among AKI survivors is common and highlights the need to understand physician and patient decision-making around NSAIDs and to develop effective strategies to reduce NSAID use in this vulnerable population. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12882-016-0411-7) contains supplementary material, which is available to authorized users.
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spelling pubmed-51220062016-11-30 High prevalence of non-steroidal anti-inflammatory drug use among acute kidney injury survivors in the southern community cohort study Lipworth, Loren Abdel-Kader, Khaled Morse, Jennifer Stewart, Thomas G. Kabagambe, Edmond K. Parr, Sharidan K. Birdwell, Kelly A. Matheny, Michael E. Hung, Adriana M. Blot, William J. Ikizler, T. Alp Siew, Edward D. BMC Nephrol Research Article BACKGROUND: Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used and have been linked to acute kidney injury (AKI), chronic kidney disease (CKD) and cardiovascular disease (CVD). Patients who survive an AKI episode are at risk for future adverse kidney and cardiovascular outcomes. The objective of our study was to examine the prevalence and predictors of NSAID use among AKI survivors. METHODS: The Southern Community Cohort Study is a prospective study of low-income adults aged 40–79 in the southeastern US. Through linkage with Centers for Medicare and Medicaid Services, 826 participants with an AKI diagnosis (ICD-9 584.5-584.9) at any age prior to cohort enrollment were identified. At baseline, data were collected on regular use of prescription and over-the-counter NSAIDs, as well as demographic, medical and other characteristics. Additional comorbidities were ascertained via linkage with CMS or the US Renal Data System. RESULTS: One hundred fifty-four AKI survivors (19%) reported regular NSAID use at cohort enrollment (52 prescription, 81 OTC, 21 both) and the percentage of NSAID users did not vary by time since AKI event. Over 58% of users were taking NSAIDS regularly both before and after their AKI event. Hypertension (83%), arthritis (71%), heart failure (44%), CKD (36%) and diabetes (35%) were prevalent among NSAID users. In a multivariable model, history of arthritis (OR: 3.00; 95% CI: 1.92, 4.68) and acetaminophen use (OR: 2.43; 95% CI: 1.50, 3.93) were significantly associated with NSAID use, while prevalent CKD (OR: 0.63; 95% CI: 0.41, 0.98) and diabetes (OR: 0.44; 95% CI: 0.29, 0.69) were significantly inversely associated. CONCLUSIONS: NSAID use among AKI survivors is common and highlights the need to understand physician and patient decision-making around NSAIDs and to develop effective strategies to reduce NSAID use in this vulnerable population. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12882-016-0411-7) contains supplementary material, which is available to authorized users. BioMed Central 2016-11-24 /pmc/articles/PMC5122006/ /pubmed/27881100 http://dx.doi.org/10.1186/s12882-016-0411-7 Text en © The Author(s). 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Lipworth, Loren
Abdel-Kader, Khaled
Morse, Jennifer
Stewart, Thomas G.
Kabagambe, Edmond K.
Parr, Sharidan K.
Birdwell, Kelly A.
Matheny, Michael E.
Hung, Adriana M.
Blot, William J.
Ikizler, T. Alp
Siew, Edward D.
High prevalence of non-steroidal anti-inflammatory drug use among acute kidney injury survivors in the southern community cohort study
title High prevalence of non-steroidal anti-inflammatory drug use among acute kidney injury survivors in the southern community cohort study
title_full High prevalence of non-steroidal anti-inflammatory drug use among acute kidney injury survivors in the southern community cohort study
title_fullStr High prevalence of non-steroidal anti-inflammatory drug use among acute kidney injury survivors in the southern community cohort study
title_full_unstemmed High prevalence of non-steroidal anti-inflammatory drug use among acute kidney injury survivors in the southern community cohort study
title_short High prevalence of non-steroidal anti-inflammatory drug use among acute kidney injury survivors in the southern community cohort study
title_sort high prevalence of non-steroidal anti-inflammatory drug use among acute kidney injury survivors in the southern community cohort study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5122006/
https://www.ncbi.nlm.nih.gov/pubmed/27881100
http://dx.doi.org/10.1186/s12882-016-0411-7
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