Ibuprofen Safest NSAID for Patients with Chronic Kidney Disease, claims study

It was a retrospective study of 1,982,488 subjects aged 18 years or older with baseline eGFR ≥60 ml/min per 1.73 m2. The researchers used multivariable Cox proportional hazards regression adjusted for each patient's baseline characteristics to examine the association between nonsteroidal anti-inflammatory drug and incident eGFR <60 ml/min per 1.73 m2 or eGFR decline ≥30% with baseline reference.

Key findings of the study were:

• After a median follow-up duration of 6.3 years, the researchers identified 14% of incident eGFR <60 ml/min per 1.73 m2 and 21% events of eGFR decline ≥30%.
• After adjusting for each patient's baseline characteristics, they found that NSAIDs significantly increases the risk of incident eGFR <60 ml/min per 1.73 m2 (hazard ratio, 1.71) and eGFR decline ≥30% (HR1.93) when compared with no NSAID.
• They noted that among NSAIDs, etoricoxib exhibited the highest risk of eGFR<60 ml/min per 1.73 m2 (HR, 3.12) and eGFR decline ≥30% (HR, 3.11) and ibuprofen displayed the lowest risk of eGFR<60 ml/min per 1.73 m2 (HR, 1.12) and eGFR decline ≥30% (HR, 1.32).

The authors concluded, "Nonsteroidal anti-inflammatory drug exposure was associated with higher risks of incident eGFR <60 ml/min per 1.73 m2 and eGFR decline ≥30%. Highest risk was observed in etoricoxib users, and lowest risk was with ibuprofen."

For further information:

DOI: https://doi.org/10.2215/CJN.18501120