Abstract: FR-PO0278
Choosing Wisely for Patients with Kidney Diseases: Nonsteroidal Anti-Inflammatory Drug Prescriptions in an Acute Care Hospital
Session Information
- CKD: Omics, Systemic Stressors, and Targeted Pharmacotherapy
October 23, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2201 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention
Authors
- Yeo, Yan Ting, Singapore General Hospital, Singapore, Singapore
- Lee, Puay hoon, Singapore General Hospital, Singapore, Singapore
- Lim, Cynthia Ciwei, Singapore General Hospital, Singapore, Singapore
Background
Chronic kidney disease (CKD) is associated with increased risk of acute kidney injury, cardiovascular complications, and gastrointestinal bleeding, making non-steroidal anti-inflammatory drugs (NSAIDs) particularly concerning in this population. Although international recommendations, including the Choosing Wisely campaign, advise avoiding NSAIDs in individuals with hypertension, heart failure, or CKD, their use remains common. Understanding the extent of NSAID prescribing in high-risk groups is therefore important to inform targeted interventions. This study describes the burden and patterns of potentially inappropriate NSAID prescriptions among hospitalized patients with reduced kidney function in an acute care tertiary hospital.
Methods
We performed a retrospective single-centre cross-sectional study of hospitalized adults with reduced kidney function (estimated glomerular filtration rate [eGFR] 15–60 mL/min/1.73 m2) admitted between January 2023 and December 2024. Electronic prescribing records identified NSAID prescriptions during hospitalization and at discharge. Prolonged NSAID therapy was defined as prescriptions lasting more than 14 days. Patients were classified according to kidney-risk factors (older age, CKD severity, concurrent kidney-risk medications) and bleeding-risk conditions. Statistical analyses used Mann–Whitney U, chi-square, or Fisher's exact tests as appropriate.
Results
A total of 708 hospitalized patients with reduced kidney function received at least one dose of NSAID. The median age was 72 (64, 77) years, and most were managed by surgical services. Although prescribing frequency declined with advancing CKD stage, substantial NSAID use persisted across high-risk categories, including 521 older adults, 299 patients on kidney-risk medications, and 293 patients receiving bleeding-risk medications. Prolonged NSAID therapy occurred in 61 patients (8.6%). Prolonged NSAID users were more often discharged by surgical specialties. No significant differences were observed in age, CKD stage, or ASCVD prevalence between prolonged and shorter NSAID users.
Conclusion
This study identified high-risk groups with substantial NSAID use. Targeted strategies, such as electronic medication alerts and pharmacist-managed programs, may help reduce avoidable harm in this population.