Nonsteroidal Anti-Infl ammatory Drug Use Among Persons With Chronic Kidney

PURPOSE Because avoidance of nonsteroidal anti-infl ammatory drugs (NSAIDs) is recommended for most individuals with chronic kidney disease (CKD), we sought to characterize patterns of NSAID use among persons with CKD in the United States. METHODS A total of 12,065 adult (aged 20 years or older) participants in the cross-sectional National Health and Nutrition Examination Survey (1999-2004) responded to a questionnaire regarding their use of over-the-counter and pre-scription NSAIDs. NSAIDs (excluding aspirin and acetaminophen) were defi ned by self-report. CKD was categorized as no CKD, mild CKD (stages 1 and 2; urinary albumin-creatinine ratio of ≥30 mg/g) and moderate to severe CKD (stages 3 and 4; estimated glomerular fi ltration rate of 15-59 mL/min/1.73 m2). Adjusted prevalence was calculated using multivariable logistic regression with appropriate population-based weighting. RESULTS Current use (nearly every day for 30 days or longer) of any NSAID was reported by 2.5%, 2.5%, and 5.0 % of the US population with no, mild, and moderate to severe CKD, respectively; nearly all of the NSAIDs used were avail-able over-the-counter. Among those with moderate to severe CKD who were currently using NSAIDs, 10.2 % had a current NSAID prescription and 66.1 % had used NSAIDs for 1 year or longer. Among those with CKD, disease awareness was not associated with reduced current NSAID use: (3.8 % vs 3.9%, aware vs unaware; P =.979). CONCLUSIONS Physicians and other health care clinicians should be aware of use of NSAIDs among those with CKD in the United States and evaluate NSAID use in their CKD patients. Ann Fam Med 2011;9:423-430. doi:10.1370/afm.1302