By: Michelle Rizzo for Knee1
Recent findings published in the American Journal of Kidney Diseases suggest that the use of nonsteroidal anti-inflammatory drugs (NSAIDs) increases the risk of developing acute renal failure.
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“NSAIDs are one of the most ubiquitous therapeutic classes of drugs, being sold as prescription and over-the-counter for a wide range of minor and major conditions involving either pain and/or inflammation,” said lead author Dr. Consuelo Huerta, from CEIFE, in Madrid, Spain.
The researchers conducted a nested case-control study to assess the risk for nonfatal acute renal failure associated with the use of NSAIDs. Included in the analysis were 386,916 patients between the ages of 50 and 84 years who were free of known cancer, renal disorder, cirrhosis, or systemic connective tissue disease. Of these, 103 patients were confirmed as having acute renal failure and were compared with 500 matched controls.
The risk for acute renal failure was three times greater among NSAID users than among non-NSAID users. After the treatment was discontinued, the risk decreased. People who were treated with long-term therapy or with high doses of NSAIDs had a slightly increased risk.
The investigators report that a history of heart failure, hypertension, and diabetes were all associated with a greater risk for acute renal failure. Hospitalizations and consultant visits in the previous years were also linked to a higher risk.
Patients who were using certain cardiovascular drugs had five times the risk of developing acute renal failure. The greatest risk was observed among those taking diuretics. A significantly increased risk was seen in patients taking a combination of NSAIDs and diuretics or NSAIDs and calcium channel blockers.
“Our study adds to the existing evidence that NSAIDs should be administered with caution to the elderly and especially to patients with a low circulating plasma volume and/or renal function already compromised; namely patients with heart failure or hypertension,” Dr. Huerta said.