title: Nonsteroidal anti-inflammatory drug use among persons with chronic kidney disease in the United States.
abstract: OBJECTIVE
  Because avoidance of nonsteroidal anti-inflammatory 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 prescription NSAIDs. NSAIDs (excluding aspirin and acetaminophen) were defined 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 filtration rate of 15-59 mL/min/1.73 m(2)). 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 available 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.
authors.affiliation: Department of Medicine, University of California, San Francisco, California, USA. laura.plantinga@emory.edu
authors.forename: Laura
authors.initials: L
authors.lastname: Plantinga
authors.forename: Vanessa
authors.initials: V
authors.lastname: Grubbs
authors.forename: Urmimala
authors.initials: U
authors.lastname: Sarkar
authors.forename: Chi-Yuan
authors.initials: CY
authors.lastname: Hsu
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Hedgeman
authors.forename: Bruce
authors.initials: B
authors.lastname: Robinson
authors.forename: Rajiv
authors.initials: R
authors.lastname: Saran
authors.forename: Linda
authors.initials: L
authors.lastname: Geiss
authors.forename: Nilka Ríos
authors.initials: NR
authors.lastname: Burrows
authors.forename: Mark
authors.initials: M
authors.lastname: Eberhardt
authors.forename: Neil
authors.initials: N
authors.lastname: Powe
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D057911:Angiotensin Receptor Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D004366:Nonprescription Drugs / Q000627:therapeutic use; D055553:Prescription Drugs / Q000627:therapeutic use; D051436:Renal Insufficiency, Chronic / Q000139:chemically induced; D012720:Severity of Illness Index; D014481:United States
chemical_list: D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000894:Anti-Inflammatory Agents, Non-Steroidal; D004366:Nonprescription Drugs; D055553:Prescription Drugs