Abstract
AimsNonsteroidal anti-inflammatory drugs (NSAIDs) are the cornerstone of pain management. There are no detailed data on NSAIDs use in Poland, especially in patients with chronic kidney disease (CKD). The aim of this study was to evaluate the frequency, circumstances, and causes of NSAIDs use as well as knowledge of their side-effects in patients with CKD.MethodThis cross-sectional study was conducted in 972 individuals with CKD, enrolled in a written survey originally developed by the authors. There were 574 patients with CKD stage I-IV, 414 patients after renal transplantation stage II-IV (CKDT) and 84 dialyzed patients (44 peritoneal, 40 hemodialysis).ResultsAmong the entire study group, 16.9 % of patients used NSAIDs every day, or several times a week. The average number of tablets taken within a month was 21.8. Subgroup analysis revealed that NSAIDs were taken most often by patients on hemodialysis: 35 % of them used NSAIDs every day or several times a week (43.15 pills per month). The most common reason for using NSAIDs were bone-joint pain (29.3 %) and headache (26.2 %). Side effects of painkillers such as renal function deterioration and the possible promotion of stomach ulcers were experienced by 43.6 and 37.6 % of respondents, respectively.ConclusionPatients with CKD often take NSAIDs. This applies especially to the group of people undergoing hemodialysis, which is mainly associated with chronic osteo-articular pain. The results also show a low awareness of painkillers’ adverse effects.
Highlights
Almost 40 % of patients visit primary care providers due to mild to moderate acute pain [1]
There were 574 patients with chronic kidney disease (CKD) stage I-IV, 314 patients after kidney transplantation (CKDT), and 84 dialyzed patients: 44 peritoneal (PD) and 40 hemodialysis (HD)
Hemodialysis patients were the oldest compared to the other subgroups (ANOVA: p < 0.001)
Summary
Almost 40 % of patients visit primary care providers due to mild to moderate acute pain [1]. In Poland, 24 % of the general population, in the case of discomfort or pain, prefer self-treatment using pharmaceuticals, including non-steroid anti-inflammatory drugs (NSAIDs), to the doctor’s advice [2]. 70 % of people aged over 65 years use NSAIDs at least once a week, and half of them take at least 7 doses per week. Both traditional NSAIDs, and the second generation cyclooxygenase-2 inhibitors offer superior efficacy compared with acetaminophen, but they carry a significant risk for serious gastrointestinal, cardiovascular and renal adverse events [5, 6]. NSAIDs use has been associated with both acute kidney injury in the general
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