Abstract
BackgroundNon-steroidal anti-inflammatory drugs (NSAIDs) should be avoided among chronic kidney disease (CKD) patients. Till now, limited data are available on NSAID use in Egypt, and we aimed to study the prevalence and pattern of NSAID use among CKD patients.MethodsA cross-sectional study was done among 350 CKD adult patients presented to the Main Alexandria University Hospital. Those with end-stage renal disease and diagnosed with acute renal injury and pregnant women were excluded. Demographic and clinical data were collected by interviewing eligible patients. Data about the pattern, history of drug-drug interactions, and knowledge about the NSAID side effects were also gathered.ResultsOf the enrolled patients, 57.1% were hypertensive, 46% were diabetics, 28% had osteoarthritis, and 18.3% had cardiovascular disease. CKD stages were 3.7%, 40.3%, and 56% in stages 2, 3, and 4, respectively. Almost two thirds (65.7%) were NSAID users. Among them, 82.6% were regular users. Headache was the most reported (68.7%) reason of use. The use of drugs which may have drug-drug interaction with the NSAIDs (as diuretics or renin-angiotensin-aldosterone system inhibitors) was reported in 36%. In multiple logistic regression, the odds of NSAID use decreased by 4% (odds ratio (OR) = 0.96, 95% confidence interval (CI) 0.93–0.99, p = 0.01) for every year increase in the patient’s age and decreased by 3% (OR = 0.97, 95% CI 0.95–0.99, p = 0.01) for every 1 ml/min/1.73 m2 increase in glomerular filtration rate.ConclusionDespite the hazards of NSAID use on the kidney, still high proportion of CKD patients are using them for a long period and they are simultaneously using other drugs with possible drug-drug interactions. This study provided important information that would decrease the gap in knowledge about the use of NSAID in Egypt. It is recommended that NSAIDs should be used with caution among CKD patients and patients should be advised about its adverse health consequences.
Highlights
1 Introduction Both over-the-counter and prescribed non-steroidal anti-inflammatory drugs (NSAIDs) are widely used all over the world. It is commonly used for the management of inflammation and pain, several guidelines including the Kidney Disease Initiative Global Outcome (KDIGO) guidelines recommended avoidance of Non-steroidal anti-inflammatory drugs (NSAIDs) for most patients with chronic kidney disease (CKD) [1]
More than half (56%) of the patients were in stage 4 CKD, and 40.3% were in stage 3 CKD
The pattern of NSAIDs in the current study showed that 40% of CKD patients used NSAIDs twice a week, 20.4% three times a week, and 22% every day
Summary
Both over-the-counter and prescribed non-steroidal anti-inflammatory drugs (NSAIDs) are widely used all over the world. The use of NSAIDs has been associated with renal function deterioration through variable mechanisms including alteration of the intraglomerular hemodynamic, nephrotic syndrome, glomerulonephritis, chronic interstitial nephritis, renal papillary necrosis, hyperkalemia, and podocyte injury [2,3,4]. This could lead to renal impairment and worsen the degree of renal dysfunction in CKD patients up to the development of end-stage renal disease (ESRD) [5]. Till limited data are available on NSAID use in Egypt, and we aimed to study the prevalence and pattern of NSAID use among CKD patients
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