Association Between Prescription Opioid Use and Biomarkers of Kidney Disease in US Adults

Abstract

Background/Aims: Prescription opioid use is increasing despite concerns about drug safety. We examined relationships between use of analgesics with biomarkers of chronic kidney disease (CKD) in a representative sample of adults in the United States (US). Methods: Participants (n=3980) were from the National Health and Nutrition Examination Survey (NHANES) 2009-2010. Use of any analgesic, prescription opioids, and NSAIDs were compared to referent groups with use of non-analgesic prescription medication or use of no prescription medication. CKD biomarkers including urine albumin-to-creatinine ratio (UACR) and serum-creatinine-based estimated glomerular filtration rate (eGFR; CKD Epidemiology Collaboration: CKD-EPI equation) were analyzed as continuous and binary variables (UACR ≥30 mg/g or eGFR <60 mL/min per 1.73m²; median splits). Results: Frequencies of use were: any prescription analgesic 12.7% (507/3980); prescription opioids 5.1% (204/3980); NSAIDs 5.6% (224/3980); non-analgesic medication 38.7% (1540/3980); no medication 48.6% (1933/3980). Prescription analgesic use (β=0.17, p=0.021) and opioid use (β=0.19, p=0.002) were associated with higher UACR values, while NSAID use was not (β=0.17, p=0.105). Prescription analgesic use was related to UACR ≥5.98 mg/g (median), (OR=1.34, 95%CI=1.01-7.79, p=0.045). No type of analgesic use was related to CKD-EPI eGFR. Conclusion: In a representative US population, prescription opioid use associated with higher albuminuria levels compared to non-opioid-users.