Abstract: FR-PO421

Non-Steroidal Anti-Inflammatory Drug (NSAID) Use and ESRD in the Southern Community Cohort Study (SCCS)

Session Information

Category: Chronic Kidney Disease (Non-Dialysis)

  • 301 CKD: Risk Factors for Incidence and Progression

Authors

  • Bock, Fabian, Vanderbilt University Medical Center, Nashville, Tennessee, United States
  • Siew, Edward D., Vanderbilt University Medical Center, Nashville, Tennessee, United States
  • Morse, Jennifer, Vanderbilt University Medical Center, Nashville, Tennessee, United States
  • Stewart, Thomas G., Vanderbilt University Medical Center, Nashville, Tennessee, United States
  • Blot, William J., Vanderbilt University Medical Center, Nashville, Tennessee, United States
  • Ikizler, Talat Alp, Vanderbilt University Medical Center, Nashville, Tennessee, United States
  • Lipworth, Loren, Vanderbilt University Medical Center, Nashville, Tennessee, United States
Background

Evidence suggests increased ESRD risk among NSAID users, but data are inconsistent and limited, particularly among blacks at high ESRD risk. The SCCS is a prospective study of ~86,000 individuals, two thirds black, in the southeastern US, where ESRD rates are high.

Methods

We assembled a case-cohort study from the SCCS, comprising 292 incident ESRD cases, identified by linkage with the US Renal Data System through March 2015, and a probability sample of 1453 SCCS participants, who donated a blood sample and had serum creatinine measured. Data were collected at baseline on regular use (2 times/week for >one month) of prescription and OTC analgesics, including NSAIDs. The analysis was restricted to those who reported using any analgesic. The association of NSAID use with ESRD was estimated with a logistic regression model adjusted for age, sex, race, smoking, hypertension, diabetes, arthritis, baseline eGFR, aspirin, acetaminophen, and an estimated propensity score (PS). The PS is the covariate-adjusted probability of being an NSAID user and was calculated with predictors of NSAID use as covariates.

Results

At enrollment, mean (SD) age was 53 (8) and 55 (9) years among ESRD cases and subcohort controls, and 78% and 62%, respectively, were black. Median (25th, 75th percentile) baseline eGFR of cases and controls was 78 (39, 109) and 98 (83, 113) ml/min/1.73 m2, respectively. Overall, NSAID, aspirin and acetaminophen use were reported by 38%, 53% and 33% of ESRD cases, respectively, compared to 53%, 40% and 33% of controls. Table 1 shows the distribution of analgesic use by baseline eGFR. In adjusted analyses, compared to non-NSAID analgesic users, the OR (95% CI) for the association between NSAID use and ESRD was 0.83 (0.54-1.27).

Conclusion

Among analgesics users, 25% of cases with baseline eGFR<60 used NSAIDs, but NSAID use was not significantly associated with risk of ESRD.

Table 1
 NSAID (%)Aspirin (%)Acetaminohen (%)
eGFR (ml/min/1.73 m2)Case/SubcohortCase/SubcohortCase/Subcohort
<= 6025.2/53.059.4/39.332.9/23.8
60 < eGFR <= 9050.7/52.656.3/42.020.3/31.8
> 9043.3/53.846.6/39.237.8/34.6

Funding

  • Other NIH Support