Nonsteroidal antiinflammatory drugs and acute renal failure in elderly persons.
Nonsteroidal antiinflammatory drugs and acute renal failure in elderly persons.
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非甾体类抗炎药和老年人急性肾功能衰竭。
DOI：
10.1093/oxfordjournals.aje.a010234
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发表时间：
2000
影响因子：
5
通讯作者：
Ray,WA
中科院分区：
文献类型：
--
作者：
Griffin,MR;Yared,A;Ray,WA
非甾体类抗炎药（NSAID）抑制肾脏前列腺素可能会降低肾功能，特别是在有效循环容量低的情况下。为了评价该效应导致的肾功能恶化的风险重要性，作者在1987-1991年对年龄≥65岁的田纳西州医疗补助登记者进行了一项巢式病例对照研究。例为社区获得性急性肾功能衰竭住院患者;根据使用NSAIDs处方药的时间、持续时间和结束时间，采用人口统计学因素对他们进行选择，并从1，799例急性肾功能衰竭患者的计算机化医疗保险数据文件中收集合并症（4.51例住院/1000年），18.1%的患者目前正在使用非甾体抗炎药处方，而在9899名随机选择的人群对照中，这一比例为11.3%。使用非甾体类抗炎药可使急性肾衰竭的风险增加58%（校正比值比= 1.58; 95%可信区间（CI）：1.34，1.66）。对于占NSAID使用量35%的异丁普罗汀，与≤ 1，200 mg/天、> 1，200 - 2，400 mg/天剂量相关的比值比为0.94（95%CI：0.58，1.51）、1.89（95%CI：1.34，2.67）和2.32（95%CI：1.45，3.71）（线性趋势检验：p= 0.009）。处方NSAID使用导致每10，000年使用估计25例与肾衰竭相关的额外住院治疗。因此，NSAIDs是老年人急性肾衰竭的一个相对少见但可避免的原因。Am J Epidemiol 2000;151：488-96。
Renal prostaglandin inhibition by nonsteroidal antiinflammatory drugs(NSAIDs)may decrease renal function, especially under conditions of low effective circulating volume. To evaluate the risk important deterioration of renal function due to this effect, the authors preformed a nested case-control study using Tennessee Medicaid enrollees aged ≥65 years in 1987–1991. Cases were patients who had been hospitalized with community acquired acute renal failure; they were selected on the timing, duration, and close of prescription NSAIDs used demographic factors, and comorbidity was gathered from computerized Mdeical-Medicare data files of the 1,799 patients with acute renal failure (4.51 hospitalizations per 1, 000 preson-years), 18.1% were current users of prescrition NSAIDs as compared with 11.3% of 9, 899 randomly selected population controls, After control for demogarphic factors and commorbidity, use of NSAIDs increased the risk of acute renal failure 58%(adjusted odds ratio = 1.58; 95% confidence interval (CI): 1.34, 1.66). For ibuproten, which accounted for 35% of NSAID use, odds ratio associated with dosages of ≤ 1,200 mg/day, > 1,200—2,400 mg/day, were 0.94(95% CI: 0.58, 1.51), 1.89(95% CI: 1.34, 2.67), and 2.32(95% CI: 1.45, 3.71), respectively (test for linear trend:p= 0.009). Prescription NSAID use resulted in an estimated 25 excess hospitalizations associated with renal failure per 10,000 years of use. Thus, NSAIDs represent a relatively uncommon but avoidable cause of acute renal failure in trail elderly persons.Am J Epidemiol2000;151:488–96.