Use of non-steroidal anti-inflammatory drugs and risk of chronic kidney disease in subjects with type 2 diabetes mellitus

[[abstract]]Background: At present, our understanding about whether the use of non-steroidal anti-inflammatory drugs (NSAIDs) can lead to kidney dysfunction remains inconclusive. Objectives: In the present study, we aimed to investigate the temporal relationship between NSAIDs use and the development of chronic kidney disease (CKD) in subjects with type 2 diabetes mellitus (T2DM). Methods: • Design: We conducted a retrospective cohort study using the data from the Longitudinal Health Insurance Database for the year 2005 (LHID2005) that was derived from the National Health Insurance Research Database (NHIRD) of 2005. • Setting: A total of 57,463 subjects aged 20 and above and with T2DM were included in this study. • Main outcome measures: Subjects with newly diagnosed CKD. • Statistic analysis: We applied multivariate proportional hazards models to determine the temporal relationship between NSAIDs use and CKD development. Results: We observed a signi fi cant temporal relationship between NSAIDs use and CKD development in subjects with T2DM. Compared to subjects not taking any NSAIDs in 2007, subjects taking NSAIDs for at least 90 days in 2007 had a higher risk of CKD development (adjusted hazard ratio (AHR) = 1.29; 95%CI: 1.20 – 1.40). In subgroup analyses, subjects (irrespective of age, sex, various comorbidities, and use of antihypertensive drugs, aspirin, or acetaminophen) taking NSAIDs for at least 90 days were more likely to develop CKD than subjects taking NSAIDs for less than 90 days or not taking NSAIDs. Conclusions: The results suggest that there is a positive temporal relationship between NSAIDs use and increased risk of CKD in subjects with T2DM. The use of NSAIDs should be based on clinical evaluations of bene fi ts and risks, and should be prescribed with caution, particularly, among subjects at high-risk for CKD