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Kidney Function in Frequent Users of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

DOI: 10.4236/ojim.2020.101007, PP. 69-82

Keywords: Non-Steroidal Anti-Inflammatory Drugs, Glomerular Filtration Rate, Kidney Dysfunction, Body Mass Index, Blood Pressure

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Abstract:

Background: Non-steroidal anti-inflammatory drugs (NSAIDs) are used for managing painful conditions. They are available as cheap, over-the-counter drugs, and commonly abused. NSAIDs inhibit prostaglandins (PGs) actions on the kidneys and can cause kidney disease and hypertension, especially when used in excess doses, for prolonged period or in stressed states. Methods: The descriptive study was carried at the Orthopaedic and Family Medicine units of the Federal Medical Centre, Abeokuta. Two hundred respondents participated in the study. One hundred frequent users of NSAIDs (with daily use for ≥ 4 weeks) and age and sex-matched controls with no known risk for kidney disease and had consented were consecutively recruited. Data were entered from history, examination and investigations (urinalysis, serum electrolyte, kidney scan and biopsy). Cases with estimated glomerular filtration rate (eGFR) < 60 mls/min/1.73 m2) and dip strip proteinuria ≥ 1+ had kidney biopsy. Statistical analysis was with SPSS 21 software. Student t-test and Chi-square tests were used to compare means and proportions respectively. Pearson’s correlation test was used to determine the strength of association between independent risk factors and kidney dysfunction (KD). Results: Two hundred respondents participated in the study. Fifty one (51) females and Forty nine (49) males were recruited as cases and controls respectively. Thirteen (13) females had KD compared to 9 males, (P = 0.02). The mean age of cases with KD (63.04 yrs ± 4.21) was statistically higher than those without KD (P = 0.01). Majority of the cases were in the working population (30 - 59 yrs). Twenty two (22) frequent NSAIDs users had kidney dysfunction (KD) while six (6%) controls had KD. The proportion of subjects that used herbal medicines was higher in cases with KD than in cases without KD as well as in the controls respectively (P = 0.01). The mean kidney length and cortical thickness were significantly lower in cases with KD than in cases without KD, (P = 0.03) and (P = 0.017) respectively. The independent predictors of KD were increasing age, use of herbal remedies and duration of drug use. Conclusion: The prevalence of KD among frequent NSAIDs users was 22%, higher than controls. Risk factors identified include increasing age, use of herbal medicines, increasing body mass index (BMI), systolic blood pressure (SBP), anaemia, reduced cortical thickness and kidney volume. NSAIDs use in excess doses, prolonged period or in stressed

References

[1]  Kim, G.-H. (2008) Renal Effects of Prostaglandins and Cyclooxygenase-2 Inhibitors. Electrolyte Blood Press, 6, 35-41.
https://doi.org/10.5049/EBP.2008.6.1.35
[2]  Whelton, A. (2002) COX-2-Specific Inhibitors and the Kidneys: Effect on Hypertension and Oedema. Journal of Hypertension. Supplement, 20, S31-S35.
[3]  Patino, F.G., Olivieri, J. and Allison, J.J. (2003) Non-Steroidal Anti-Inflammatory Drug Toxicity Monitoring and Safety Practices. The Journal of Rheumatology, 30, 2680-2688.
[4]  Paulose-Ram, R., Hirsch, R., Dillon, C., Losonczy, K., Cooper, M. and Ostchega, Y. (2003) Prescription and Non-Prescription Analgesic Use among the US Adult Population: Results from the Third National Health and Nutrition Examination Survey (NHANES III). Pharmacoepidemiology and Drug Safety, 12, 315-326.
https://doi.org/10.1002/pds.755
[5]  Agaba, E.L., Agaba, P.A. and Wigwe, C.M. (2004) Use and Abuse of Analgesic in Nigeria. Nigerian Journal of Medicine, 13, 379-382.
[6]  Elseviers, M.M. and De Broe, M.E. (1995) A Long-Term Prospective Controlled Study of Analgesic Abuse in Belgium. Kidney International, 48, 1912-1919.
https://doi.org/10.1038/ki.1995.491
[7]  Pintér, I., Mátyus, J. and Czégány, Z. (2004) Analgesic Nephropathy in Hungary: The HANS Study. Nephrology Dialysis Transplantation, 19, 840-843.
https://doi.org/10.1093/ndt/gfh040
[8]  Gonzalez, F.J. and Tukey, R.H. (2006) Drug Metabolism. In: Goodman & Gilman’s Pharmacological Basis of Therapeutics, 11th Edition, Chapter 3, McGraw-Hill, Brunton, LL, 23-31.
[9]  Horl, W.H. (2010) Nonsteroidal Anti-Inflammatory Drugs and the Kidney. Pharmaceutical, 3, 2291-2321.
https://doi.org/10.3390/ph3072291
[10]  Scotney, B. and Reid, S. (2015) Body Weight, Serum Sodium Levels and Renal Function in an Ultra-Distance Mountain Run. Clinical Journal of Sport Medicine, 25, 341-346.
https://doi.org/10.1097/JSM.0000000000000131
[11]  Raghavan, R. and Eknoyan, G. (2014) Acute Interstitial Nephritis: A Reappraisal and Update. Clinical Nephrology, 82, 149-162.
https://doi.org/10.5414/CN10838
[12]  Araoye, M.O. (2003) Sample Size Determination. In: Margaret, O.A., Ed., Research Methodology with Statistics for Health and Social Sciences, Nathadex Publishers, Ilorin, Nigeria, 115-119.
[13]  Schwarz, A., Krause, P.H., Kunzendrof, V., Keller, F. and Distler, A. (2000) The Outcome of Acute Interestial Nephritis: Risk Factors for the Transition from Acute to Chronic Interstistial Nephritis. Clinical Nephrology, 54, 179-190.
[14]  De Broe, M.E. and Elseviers, M.M. (2009) Over-the-Counter Analgesic Use. Journal of the American Society of Nephrology, 20, 2098-2103.
https://doi.org/10.1681/ASN.2008101097
[15]  Freedman, B.L. (2003) APOL 1 and Nephropathy Progression in African Ancestry. Seminars in Nephrology, 33, 425-432.
https://doi.org/10.1016/j.semnephrol.2013.07.004
[16]  Kadiri, S., Arije, A. and Salako, B.L. (1999) Traditional Herbal Preparations and Acute Renal Failure in South West Nigeria. Tropical Doctor, 29, 244-246.
https://doi.org/10.1177/004947559902900419
[17]  Levey, A.S., Stevens, L.A., Schmid, C.H., Zhang, Y.L., Castro, A.F., Feldman, H.I., et al. (2009) CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) A New Equation to Estimate Glomerular Filtration Rate. Annals of Internal Medicine, 150, 604-612.
https://doi.org/10.7326/0003-4819-150-9-200905050-00006
[18]  Sean, H.C., Timothy, H.M. and McDonald, S.P. (2008) Analgesic Nephhropathy and Renal Replacement Therapy in Australia: Trend, Comobidities and Outcomes. Clinical Journal of the American Society of Nephrology, 3, 768-777.
https://doi.org/10.2215/CJN.04901107
[19]  Chang, S.H., Mathew, T.H. and McDonald, S.P. (2008) Analgesic Nephropathy and Renal Replacement Therapy in Australia: Trends, Comorbidities and Outcomes. Clinical Journal of the American Society of Nephrology, 3, 768-776.
https://doi.org/10.2215/CJN.04901107
[20]  Miller, J.A., Cherney, D.Z., Duncan, J.A., Lai, V., Burns, K.D., Kennedy, C.R.J., et al. (2006) Gender Difference in the Renal Response to Renin Angiotensin System Blockage. Journal of the American Society of Nephrology, 17, 2554-2560.
https://doi.org/10.1681/ASN.2005101095
[21]  Okoye, O.C.A., Oviasu, E. and Ojogwu, L. (2011) Prevalence of Chronic Kidney Disease and Its Risk Factors amongst Adults in a Rural Population in Edo State, Nigeria. Journal of US-China Medical Science, 8, 471-481.
[22]  Kovesty, C.P., Furth, S.L. and Zoccali, C. (2017) Obesity and Kidney Disease: Hidden Consequences of the Epidemic. Journal of Nephrology, 30, 1-10.
https://doi.org/10.1007/s40620-017-0377-y
[23]  Barri, Y.M. (2008) Hypertension and Kidney Disease: A Deadly Connection. Current Hypertension Reports, 10, 39-45.
https://doi.org/10.1007/s11906-008-0009-y
[24]  Goldstein, J.L., Chan, F.K.L., Lanas, A., Wilcox, C.M., Peura, D. and Sands, G.H. (2011) Haemoglobin Reduction in NSAIDs Users over Time: An Analysis of 2 Large Outcome Trials. Alimentary Pharmacology & Therapeutics, 34, 808-816.
https://doi.org/10.1111/j.1365-2036.2011.04790.x
[25]  Gooch, K., Culleton, B.F., Manns, B.J., Zhang, J., Alfonso, H., Tonelli, M., et al. (2007) NSAIDs Use and Progression of Chronic Kidney Disease. American Journal of Medicine, 120, 280.e1-280.e7.
https://doi.org/10.1016/j.amjmed.2006.02.015
[26]  Levey, A.S., Coresh, J., Bolton, K., Culleton, B., Harvey, K.S., Ikizler, T.A., et al. (2002) K/DOQI Clinical Practice Guidelines for Chronic Kidney Disease Evaluation, Classification and Stratification. American Journal of Kidney Diseases, 39, S1-S266.
[27]  Mackinnon, B., Boulton Jone, M. and Mclaughlin, K. (2003) Analgesic-Associated Nephropathy in the West of Scotland: A 12 Year Observational Study. Nephrology Dialysis Transplantation, 18, 1800-1809.
https://doi.org/10.1093/ndt/gfg230
[28]  Yaxley, J. (2016) Common Analgesic Agents and Their Roles in Analgesic Nephropathy: A Commentary on the Evidence. The Korean Journal of Medicine, 37, 310-316.
https://doi.org/10.4082/kjfm.2016.37.6.310
[29]  Rexrode, K.M., Buring, J.E., Glynn, R.J., Stampfer, M.J., Youngman, L.D. and Gaziano, J.M. (2001) Analgesic Use and Renal in Men. The Journal of the American Medical Association, 286, 315-321.
https://doi.org/10.1001/jama.286.3.315
[30]  Beland, M.D., Walle, N.L., Machan, J.T. and Cronan, J.J. (2010) Renal Cortical Thickness Measured at Ultrasound: Is It Better than Renal Length as an Indicator of Renal Function in Chronic Kidney Disease? American Journal of Roentgenology, 195, 146-149.
https://doi.org/10.2214/AJR.09.4104
[31]  Brown, P. (2003) Ultrasound in Diffuse Renal Disease. British Medical Ultrasound Society’s Bulletin, 11, 30-34.
https://doi.org/10.1177/1742271X0301100406
[32]  Postshil, I.A. (1995) Pathomorphology of Kidney Lesions Induced by NSAIDs. Arkhiv Patologii, 57, 70-74.
[33]  Mihovilovic, K., Ljubanovic, D. and Knotek, M. (2011) Safe Administration of Celecoxib to a Patient with Repeated Episodes of Nephrotic Syndrome Induced by NSAIDs. Clinical Drug Investigation, 31, 351-355.
https://doi.org/10.1007/BF03256934

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