title: Use of Nonsteroidal Anti-Inflammatory Drugs and Risk of Chronic Kidney Disease in Subjects With Hypertension: Nationwide Longitudinal Cohort Study.
abstract: Limited studies have examined the effects of nonsteroidal anti-inflammatory drug (NSAID) use on the risk of chronic kidney disease (CKD), especially in subjects with hypertension. Using National Health Insurance claims data in Taiwan, we conducted a propensity score-matched cohort study to investigate the relationship between NSAID use and CKD in subjects with hypertension. A total of 31976 subjects were included in this study: subjects not taking any NSAIDs in 2007 (n=10782); subjects taking NSAIDs for 1 to 89 days in 2007 (n=10605); and subjects taking NSAIDs for ≥90 days in 2007 (n=10589). We performed multivariable proportional hazard models to determine the relationship between NSAID use and CKD. The results showed that NSAID use was associated with a 1.18-fold increased risk of CKD in subjects taking NSAIDs for 1 to 89 days; and a 1.32-fold increased risk of CKD in hypertension subjects taking NSAIDs for ≥90 days, compared with subjects not taking any NSAIDs, after controlling for the confounding factors. In subgroup analyses, subjects taking NSAIDs for ≥90 days, >1 defined daily dose per day or taking NSAIDs >15 cumulative defined daily doses had a greater risk of CKD than subjects not taking any NSAID, but not for congestive heart failure, stroke, cancer, osteoarthritis, or rheumatoid arthritis. These results provide supportive evidence that NSAID use is associated with increased risk of CKD in subjects with hypertension. It is important to closely monitor the effects of NSAID use, particularly in patients with hypertension, a susceptible population for CKD.
authors.affiliation: From the Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan (C.-C.H., S.-Y.C., Y.-W.H., Y.-K.C., J.-S.L., C.A.H., H.-J.T.); Departments of Health Services Administration (C.-C.H., Y.-H.H.) and Public Health (H.-J.T.), China Medical University, Taichuang City, Taiwan; Department of Cardiovascular Internal Medicine, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Beijing, China (H.W.); National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (H.W.); Division of Nephrology, Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi City, Taiwan (Y.-H.H.); Department of Nursing, Min-Hwei College of Health Care Management, Tainan City, Taiwan (Y.-H.H.); and Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL (H.-J.T.).
authors.forename: Chih-Cheng
authors.initials: CC
authors.lastname: Hsu
authors.affiliation: From the Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan (C.-C.H., S.-Y.C., Y.-W.H., Y.-K.C., J.-S.L., C.A.H., H.-J.T.); Departments of Health Services Administration (C.-C.H., Y.-H.H.) and Public Health (H.-J.T.), China Medical University, Taichuang City, Taiwan; Department of Cardiovascular Internal Medicine, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Beijing, China (H.W.); National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (H.W.); Division of Nephrology, Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi City, Taiwan (Y.-H.H.); Department of Nursing, Min-Hwei College of Health Care Management, Tainan City, Taiwan (Y.-H.H.); and Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL (H.-J.T.).
authors.forename: Hongjian
authors.initials: H
authors.lastname: Wang
authors.affiliation: From the Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan (C.-C.H., S.-Y.C., Y.-W.H., Y.-K.C., J.-S.L., C.A.H., H.-J.T.); Departments of Health Services Administration (C.-C.H., Y.-H.H.) and Public Health (H.-J.T.), China Medical University, Taichuang City, Taiwan; Department of Cardiovascular Internal Medicine, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Beijing, China (H.W.); National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (H.W.); Division of Nephrology, Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi City, Taiwan (Y.-H.H.); Department of Nursing, Min-Hwei College of Health Care Management, Tainan City, Taiwan (Y.-H.H.); and Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL (H.-J.T.).
authors.forename: Yueh-Han
authors.initials: YH
authors.lastname: Hsu
authors.affiliation: From the Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan (C.-C.H., S.-Y.C., Y.-W.H., Y.-K.C., J.-S.L., C.A.H., H.-J.T.); Departments of Health Services Administration (C.-C.H., Y.-H.H.) and Public Health (H.-J.T.), China Medical University, Taichuang City, Taiwan; Department of Cardiovascular Internal Medicine, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Beijing, China (H.W.); National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (H.W.); Division of Nephrology, Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi City, Taiwan (Y.-H.H.); Department of Nursing, Min-Hwei College of Health Care Management, Tainan City, Taiwan (Y.-H.H.); and Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL (H.-J.T.).
authors.forename: Shao-Yuan
authors.initials: SY
authors.lastname: Chuang
authors.affiliation: From the Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan (C.-C.H., S.-Y.C., Y.-W.H., Y.-K.C., J.-S.L., C.A.H., H.-J.T.); Departments of Health Services Administration (C.-C.H., Y.-H.H.) and Public Health (H.-J.T.), China Medical University, Taichuang City, Taiwan; Department of Cardiovascular Internal Medicine, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Beijing, China (H.W.); National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (H.W.); Division of Nephrology, Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi City, Taiwan (Y.-H.H.); Department of Nursing, Min-Hwei College of Health Care Management, Tainan City, Taiwan (Y.-H.H.); and Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL (H.-J.T.).
authors.forename: Ya-Wen
authors.initials: YW
authors.lastname: Huang
authors.affiliation: From the Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan (C.-C.H., S.-Y.C., Y.-W.H., Y.-K.C., J.-S.L., C.A.H., H.-J.T.); Departments of Health Services Administration (C.-C.H., Y.-H.H.) and Public Health (H.-J.T.), China Medical University, Taichuang City, Taiwan; Department of Cardiovascular Internal Medicine, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Beijing, China (H.W.); National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (H.W.); Division of Nephrology, Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi City, Taiwan (Y.-H.H.); Department of Nursing, Min-Hwei College of Health Care Management, Tainan City, Taiwan (Y.-H.H.); and Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL (H.-J.T.).
authors.forename: Yu-Kang
authors.initials: YK
authors.lastname: Chang
authors.affiliation: From the Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan (C.-C.H., S.-Y.C., Y.-W.H., Y.-K.C., J.-S.L., C.A.H., H.-J.T.); Departments of Health Services Administration (C.-C.H., Y.-H.H.) and Public Health (H.-J.T.), China Medical University, Taichuang City, Taiwan; Department of Cardiovascular Internal Medicine, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Beijing, China (H.W.); National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (H.W.); Division of Nephrology, Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi City, Taiwan (Y.-H.H.); Department of Nursing, Min-Hwei College of Health Care Management, Tainan City, Taiwan (Y.-H.H.); and Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL (H.-J.T.).
authors.forename: Jia-Sin
authors.initials: JS
authors.lastname: Liu
authors.affiliation: From the Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan (C.-C.H., S.-Y.C., Y.-W.H., Y.-K.C., J.-S.L., C.A.H., H.-J.T.); Departments of Health Services Administration (C.-C.H., Y.-H.H.) and Public Health (H.-J.T.), China Medical University, Taichuang City, Taiwan; Department of Cardiovascular Internal Medicine, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Beijing, China (H.W.); National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (H.W.); Division of Nephrology, Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi City, Taiwan (Y.-H.H.); Department of Nursing, Min-Hwei College of Health Care Management, Tainan City, Taiwan (Y.-H.H.); and Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL (H.-J.T.).
authors.forename: Chao A
authors.initials: CA
authors.lastname: Hsiung
authors.affiliation: From the Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan (C.-C.H., S.-Y.C., Y.-W.H., Y.-K.C., J.-S.L., C.A.H., H.-J.T.); Departments of Health Services Administration (C.-C.H., Y.-H.H.) and Public Health (H.-J.T.), China Medical University, Taichuang City, Taiwan; Department of Cardiovascular Internal Medicine, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Beijing, China (H.W.); National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (H.W.); Division of Nephrology, Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi City, Taiwan (Y.-H.H.); Department of Nursing, Min-Hwei College of Health Care Management, Tainan City, Taiwan (Y.-H.H.); and Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL (H.-J.T.). tsaihj@nhri.org.tw.
authors.forename: Hui-Ju
authors.initials: HJ
authors.lastname: Tsai
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects* / Q000627:therapeutic use; D016208:Databases, Factual; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications*; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D051436:Renal Insufficiency, Chronic / Q000139:chemically induced / Q000453:epidemiology* / Q000209:etiology*; D012307:Risk Factors; D055815:Young Adult
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal
keywords: chronic kidney disease; epidemiology; hypertension; nonsteroidal anti-inflammatory agent