Association of Non-Steroidal Anti-Inflammatory Drugs with Kidney Health in Ambulatory Older Adults.
Association of Non-Steroidal Anti-Inflammatory Drugs with Kidney Health in Ambulatory Older Adults.
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DOI：
10.1111/jgs.16961
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发表时间：
2021-03
影响因子：
6.3
通讯作者：
Health ABC Study
中科院分区：
文献类型：
--
作者：
Amatruda JG;Katz R;Peralta CA;Estrella MM;Sarathy H;Fried LF;Newman AB;Parikh CR;Ix JH;Sarnak MJ;Shlipak MG;Health ABC Study
非甾体抗炎药（NSAID）可导致肾损伤，尤其是老年人。然而，先前报道的NSAID使用和肾脏健康结果之间的关联是不一致的，并且受到基于血清肌酐的GFR估计值的依赖的限制。该分析使用多种肾脏健康指标调查了NSAID使用与老年人肾损伤的相关性。横向和纵向分析。多中心、基于社区的队列研究。健康ABC研究中的2，999名老年人。随机选择子队列（n=500）进行额外的生物标志物测量。通过自我报告确定的处方和非处方NSAID使用情况。在2,999名参与者中测量了通过胱抑素C（cysC）、尿白蛋白/肌酐比值（ACR）、肾损伤分子-1（KIM-1）和白细胞介素-18（IL-18）测定的基线eGFR;在500名参与者中测量了α-1微球蛋白（α 1 m）、中性粒细胞明胶酶相关脂质运载蛋白（NGAL）、前肽III型前胶原（PIIINP）和尿调蛋白（UMOD）。GFR在10年内估计3次，并表示为每年的百分比变化。参与者的平均年龄为74岁，51%为女性，41%为非洲裔美国人。基线时，NSAID使用者（n=655）和非使用者（n=2344）之间未检测到eGFR差异（两组均为72 mL/min/1.73 m2）。与非使用者相比，NSAID使用者ACR >30 mg/g的校正几率较低（0.67; 95% CI：0.51-0.89），基线时平均尿IL-18浓度较低（−11%; 95% CI：−4%至−18%），但平均KIM-1相似（5%; 95% CI：−5%至14%）。未检测到其余尿液生物标志物的基线浓度存在显著差异。NSAID使用者和非使用者在eGFR下降率方面没有显著差异（每年-2.2% vs.-2.3%）。基于多种测量，自我报告的NSAID使用与肾功能不全或损伤无关，提高了非卧床老年人使用NSAID而不损害肾脏的可能性。需要更多的研究来定义非甾体抗炎药食用的安全模式。
Non-steroidal anti-inflammatory drugs (NSAIDs) can cause kidney injury, especially in older adults. However, previously reported associations between NSAID use and kidney health outcomes are inconsistent and limited by reliance on serum creatinine-based GFR estimates. This analysis investigated the association of NSAID use with kidney damage in older adults using multiple kidney health measures. Cross-sectional and longitudinal analyses. Multicenter, community-based cohort. 2,999 older adults in the Health ABC Study. A subcohort (n=500) was randomly selected for additional biomarker measurements. Prescription and over-the-counter NSAID use ascertained by self-report. Baseline eGFR by cystatin C (cysC), urine albumin-to-creatinine ratio (ACR), kidney injury molecule-1 (KIM-1), and interleukin-18 (IL-18) were measured in 2,999 participants; alpha-1 microglobulin (α1m), neutrophil gelatinase-associated lipocalin (NGAL), propeptide type III procollagen (PIIINP), and uromodulin (UMOD) were measured in 500 participants. GFR was estimated 3 times over 10 years and expressed as percent change per year. Participants had a mean age of 74 years, 51% were female, and 41% African-American. No eGFR differences were detected between NSAID users (n=655) and non-users (n=2344) at baseline (72 mL/min/1.73m2 in both groups). Compared to non-users, NSAID users had lower adjusted odds of having ACR >30 mg/g (0.67; 95% CI: 0.51-0.89) and lower mean urine IL-18 concentration at baseline (−11%; 95% CI: −4% to −18%), but similar mean KIM-1 (5%; 95% CI: −5% to 14%). No significant differences in baseline concentrations of the remaining urine biomarkers were detected. NSAID users and non-users did not differ significantly in the rate of eGFR decline (−2.2% vs. −2.3% per year). Self-reported NSAID use was not associated with kidney dysfunction or injury based on multiple measures, raising the possibility of NSAID use without kidney harm in ambulatory older adults. More research is needed to define safe patterns of NSAID consumption.
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影响因子：
13.2
作者：
Nadkarni, Girish N.;Chauhan, Kinsuk;Coca, Steven G.
通讯作者：
Coca, Steven G.
DOI：
10.1056/nejmoa1114248
发表时间：
2012-07-05
期刊：
The New England journal of medicine
影响因子：
--
作者：
Inker LA;Schmid CH;Tighiouart H;Eckfeldt JH;Feldman HI;Greene T;Kusek JW;Manzi J;Van Lente F;Zhang YL;Coresh J;Levey AS;CKD-EPI Investigators
通讯作者：
CKD-EPI Investigators
DOI：
10.1053/j.ajkd.2017.12.013
发表时间：
2018-08
期刊：
American journal of kidney diseases : the official journal of the National Kidney Foundation
影响因子：
--
作者：
Jotwani V;Katz R;Ix JH;Gutiérrez OM;Bennett M;Parikh CR;Cummings SR;Sarnak MJ;Shlipak MG
通讯作者：
Shlipak MG
DOI：
10.1053/j.ajkd.2014.01.432
发表时间：
2014-07
期刊：
American journal of kidney diseases : the official journal of the National Kidney Foundation
影响因子：
--
作者：
Driver TH;Katz R;Ix JH;Magnani JW;Peralta CA;Parikh CR;Fried L;Newman AB;Kritchevsky SB;Sarnak MJ;Shlipak MG;Health ABC Study
通讯作者：
Health ABC Study
影响因子：
13.2
作者：
Malhotra, Rakesh;Craven, Timothy;Ix, Joachim H.
通讯作者：
Ix, Joachim H.