Consumption of non-steroidal anti-inflammatory drugs and the development of functional renal impairment in elderly subjects. Results of a case-control study
Consumption of non-steroidal anti-inflammatory drugs and the development of functional renal impairment in elderly subjects. Results of a case-control study
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DOI：
10.1046/j.1365-2125.1997.00631.x
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发表时间：
1997-07-01
影响因子：
3.4
通讯作者：
Hall, C
中科院分区：
文献类型：
--
作者：
Henry, D;Page, J;Hall, C
目的-本研究的目的是探讨与社区使用的非甾体抗炎药（NSAIDs）的风险水平。方法我们进行了匹配的病例对照研究，最近使用的NSAIDs和功能性肾损害的存在之间的关系，目前在住院治疗的时间与一系列的临床问题。病例（n = 110）为急性入院的连续患者，其血清肌酐水平大于或等于0.15 mmol l（-1），在接下来的14天内或出院前改善20%或更多。对照组（n = 189）为与病例相同性别和年龄（至5岁以内）的受试者，他们在同一医院住院，在整个住院期间血清肌酐水平正常（< 0.12 mmol l（-1））。一些研究因素的信息，包括最近使用阿司匹林和其他非甾体抗炎药，通过结构化访谈获得。（包括非预防性阿司匹林）和在前一周或前一个月使用NSAID的功能性肾损害调整比值比（OR）的发展：OR分别为1.5（95% CI 0.80，2.9）和1.8（95% CI 0.97，3.4）。在有肾脏疾病既往史的受试者中，校正的OR为6.6（0.75，57.8），在有痛风或高尿酸血症病史的受试者中，OR为7.2（1.3，40.2）。前一周的药物剂量与功能性肾损害的几率之间存在弱正相关。风险与公布的药物半衰期（t（1/2））数据之间的关系更强。比值比从t（12）≤ 4 h时的1.2（95% CI 0.61，2.4）增加至t（12）≤ 12 h时的4.8（1.5，15.8）（P = 0.012，趋势检验）。这种关系仍然有统计学意义的一些临床变量和剂量的药物ingested.Conclusions非甾体抗炎药的调整后，在肾脏疾病或痛风或高尿酸血症史的受试者的功能性肾损害的一个重要原因。药物的半衰期比摄入剂量在确定这种结果的风险方面更重要。有肾损害风险的个体应避免使用半衰期长的药物。
Aims The aim of the present study was to explore the level of risk associated with community use of non-steroidal anti-inflammatory drugs (NSAIDs).Methods We carried out a matched case-control study of the relationship between recent use of NSAIDs and the presence of functional renal impairment present at the time of hospitalisation with a range of clinical problems. Cases (n = 110) were consecutive patients admitted acutely to hospital who had serum creatinine levels greater than or equal to 0.15 mmol l(-1), which improved by 20% or more within the next 14 days, or prior to discharge from hospital. Controls (n = 189) were subjects of the same sex and age (to within 5 years) as the cases, who were admitted to the same hospital, who had normal serum creatinine levels (< 0.12 mmol l(-1)) throughout their hospital stay. Information on a number of study factors, including recent use of aspirin and other NSAIDs, was obtained by structured interview.Results Overall, there was a weak association between consumption of NSAIDs (including non-prophylactic aspirin) and the development of functional renal impairment-adjusted odds ratios (OR) with use of NSAIDs in the previous week or in the previous month: OR 1.5 (95% CI 0.80, 2.9) and 1.8 (95% CI 0.97, 3.4) respectively. In subjects with a previous history of renal disease the adjusted OR was 6.6 (0.75, 57.8) and in those with a history of gout or hyperuricaemia the OR was 7.2 (1.3, 40.2). There was a weak positive relationship between the dose of drug consumed in the previous week and the odds of functional renal impairment. The relationship between risk and published figures for drug half-lives (t(1/2)) was stronger. The odds ratio increased from 1.2 (95% CI 0.61, 2.4) with a t(1/2) less than or equal to 4 h, to 4.8 (1.5, 15.8) with a t(1/2) of less than or equal to 12 h (P = 0.012, test for trend). This relationship remained statistically significant after adjustment for a number of clinical variables and the dose of drug ingested.Conclusions NSAIDs are an important cause of functional renal impairment in subjects with renal disease or a history of gout or hyperuricemia. The half-Life of the drug is more important than the ingested dose in determining the risk of this outcome. Long half-life drugs should be avoided in individuals who are at risk of developing renal impairment.