Association Between Prescription Opioid Use and Biomarkers of Kidney Disease in US Adults.
OBJECTIVE
Prescription opioid use is increasing despite concerns about drug safety. We examined relationships between use of analgesics with biomarkers of chronic kidney disease (CKD) in a representative sample of adults in the United States (US).


METHODS
Participants (n=3980) were from the National Health and Nutrition Examination Survey (NHANES) 2009-2010. Use of any analgesic, prescription opioids, and NSAIDs were compared to referent groups with use of non-analgesic prescription medication or use of no prescription medication. CKD biomarkers including urine albumin-to-creatinine ratio (UACR) and serum-creatinine-based estimated glomerular filtration rate (eGFR; CKD Epidemiology Collaboration: CKD-EPI equation) were analyzed as continuous and binary variables (UACR ≥30 mg/g or eGFR <60 mL/min per 1.73m2; median splits).


RESULTS
Frequencies of use were: any prescription analgesic 12.7% (507/3980); prescription opioids 5.1% (204/3980); NSAIDs 5.6% (224/3980); non-analgesic medication 38.7% (1540/3980); no medication 48.6% (1933/3980). Prescription analgesic use (β=0.17, p=0.021) and opioid use (β=0.19, p=0.002) were associated with higher UACR values, while NSAID use was not (β=0.17, p=0.105). Prescription analgesic use was related to UACR ≥5.98 mg/g (median), (OR=1.34, 95%CI=1.01-7.79, p=0.045). No type of analgesic use was related to CKD-EPI eGFR.


CONCLUSIONS
In a representative US population, prescription opioid use associated with higher albuminuria levels compared to non-opioid-users.
College of Nursing, Washington State University, Spokane, WA, USA.
Celestina
C
Barbosa-Leiker
Sterling
S
McPherson
Kenn
K
Daratha
Radica
R
Alicic
Robert
R
Short
Brad
B
Dieter
Naomi
N
Chaytor
John
J
Roll
Katherine R
KR
Tuttle
D000328:Adult; D000419:Albuminuria / Q000139:chemically induced* / Q000453:epidemiology; D000700:Analgesics / Q000009:adverse effects; D000701:Analgesics, Opioid / Q000009:adverse effects* / Q000627:therapeutic use; D015415:Biomarkers / Q000652:urine; D006801:Humans; D055553:Prescription Drugs; D051436:Renal Insufficiency, Chronic / Q000139:chemically induced* / Q000453:epidemiology; D014481:United States
D000700:Analgesics; D000701:Analgesics, Opioid; D015415:Biomarkers; D055553:Prescription Drugs