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Abstract: TH-PO1164

Use of Opioids and Nonsteroidal Anti-Inflammatory Drugs in Living Kidney Donors: Clinical Correlates and Early Outcomes

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • Lentine, Krista L., Saint Louis University, St. Louis, Missouri, United States
  • Vest, Luke S., Saint Louis University, St. Louis, Missouri, United States
  • Sarabu, Nagaraju, Cleveland Med Center, Cleveland, Ohio, United States
  • Lam, Ngan, University of Alberta, Edmonton, Alberta, Canada
  • Koraishy, Farrukh M., Saint Louis University, St. Louis, Missouri, United States
  • Schnitzler, Mark, Saint Louis Univ, Shiloh, Illinois, United States
Background

Limited data are available on pain medication use in living kidney donors (LKD). While there is growing national concern related to opioids, there is also concern for non-steroidal anti-inflammatory (NSAID) use due to potential nephrotoxicity.

Methods

We examined a novel database wherein national LKD registry identifiers were linked to records from a large U.S. pharmaceutical claims warehouse (2007 to 2017 fills). We selected LKD with 1 year of postdonation pharmaceutical fill records. Associations of baseline demographic and clinical factors with opioid and NSAID use (adjusted odds ratio, 95% LCL aHR 95% UCL) were quantified by multivariate logistic regression.

Results

Among 23,564 eligible LKD, opioid use declined postdonation: 36.6%, mos. >0-0.5; 14.7%, mos. 0.6-6; 12.6%, mos. 7-12. NSAID use was uncommon, but increased: 0.5%, mos. >0-0.5; 2.2%, mos. 0.6-6; 3.3%, mos. 7-12. With adjustment including predonation estimated glomerular filtration rate, hypertension, donor-recipient relationship and nephrectomy type, opioid use in mos. 7-12 was associated (P<0.05) with female sex (1.131.241.35), black race (1.031.171.32), obesity (1.241.381.53), lower education (1.191.311.43), not working (1.021.121.24), smoking (1.331.451.58), and surgical complications (1.111.291.49) (Fig.). NSAID use was more common in women, black and Hispanic LKD, obese LKD, those with lower education, not working, and with surgical complications. Patterns were similar in earlier postdonation periods. Neither opioids nor NSAIDs were associated with eGFR change or proteinuria to 2 years

Conclusion

Opioid and NSAID use in LKD vary with demographic and clinical traits. Work is needed to define safety and optimal choice of pain medications in LKD.

Fig 1. Associations of baseline traits with pain medication use