Association of Individual Non-Steroidal Anti-Inflammatory Drugs and Chronic Kidney Disease : A Population-Based Case Control Study
Ingrasciotta, Ylenia (University of Messina, Italy)
Sultana, Janet (University of Messina, Italy)
Giorgianni, Francesco (University of Messina, Italy)
Fontana, Andrea (Unit of Biostatistics, IRCCS "Casa Sollievo della Sofferenza", San Giovanni Rotondo (FG), Italy)
Santangelo, Antonio (University of Messina, Italy)
Tari, Daniele Ugo (Caserta Local Health Service, Italy)
Santoro, Domenico (University of Messina, Italy)
Arcoraci, Vincenzo (University of Messina, Italy)
Perrotta, Margherita (Caserta Local Health Service, Italy)
Ibanez, Luisa (Universitat Autònoma de Barcelona. Departament de Farmacologia, de Terapèutica i de Toxicologia)
Trifirò, Gianluca (University of Messina, Italy)

Date:	2015
Abstract:	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. 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. 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. 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). 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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Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Published in:	PloS one, Vol. 10 (april 2015) , ISSN 1932-6203

DOI: 10.1371/journal.pone.0122899
PMID: 25880729

14 p, 775.2 KB

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