ASN's Mission

ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: SA-PO617

Prevalence and Adverse Outcomes Associated with Opioid Prescriptions Across the Range of eGFR

Session Information

  • Pharmacology
    October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Pharmacology (PharmacoKinetics, -Dynamics, -Genomics)

  • 1700 Pharmacology (PharmacoKinetics, -Dynamics, -Genomics)

Authors

  • Novick, Tessa Kimberly, Johns Hopkins University, Baltimore, Maryland, United States
  • Surapaneni, Aditya L., Johns Hopkins University, Baltimore, Maryland, United States
  • Shin, Jung-Im, Johns Hopkins University, Baltimore, Maryland, United States
  • Alexander, G caleb, Johns Hopkins University, Baltimore, Maryland, United States
  • Inker, Lesley, Tufts Medical Center, Boston, Massachusetts, United States
  • Chang, Alex R., Geisinger Medical Center, Danville, Pennsylvania, United States
  • Grams, Morgan, Johns Hopkins University, Baltimore, Maryland, United States
Background

Kidney disease limits therapeutic options for pain control given the relative contraindication to non-steroidal antiflammatory drugs. The goal of this study was to assess the prevalence and safety of prescription opioid use across the range of eGFR in a U.S. outpatient population.

Methods

Using electronic medical records from the Geisinger Health System, we described trends in opioid prescriptions by CKD stage between 2011 and 2016. In a cohort matched on propensity for ≥2 opioid prescriptions during a 2-year baseline period (2011-2013) we used Cox proportional hazards regression to evaluate the association between opiate prescription compared to no opiate prescription and death, total hospitalizations, non-pathologic fracture, and presentations for altered mental status, as well as whether associations differed by eGFR level.

Results

Opioid prescriptions increased over time, particularly among patients with eGFR < 30 ml/min/1.73m2. For example, 43.5% patients with eGFR < 30 ml/min were prescribed opioids in 2011 compared to 46.4% in 2016 (p for trend < 0.001). Among 22,261 patients receiving at least two opiate prescriptions during the baseline period, a suitable match was found for 5,337 based on 23 clinical and demographic covariates. Patients with opioid prescriptions had significantly increased risk for death (HR 1.39, 95% CI 1.16-1.67), hospitalization (HR 1.51, 95% CI 1.39-1.63), and non-pathologic fracture (HR 1.51, 95% CI 1.33-1.72) compared to their counterparts for all levels of eGFR (p >0.05), but differences in altered mental status were not statistically significant (HR 1.22, 95% CI 0.79-1.88) (Figure).

Conclusion

Opioid prescriptions are common in patients with CKD and are associated with higher risk for death, hospital admissions and non-pathologic fracture.