Influence of creatinine versus glomerular filtration rate on non-steroidal anti-inflammatory drug prescriptions in chronic kidney disease.
Influence of creatinine versus glomerular filtration rate on non-steroidal anti-inflammatory drug prescriptions in chronic kidney disease.
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DOI：
10.1159/000339439
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发表时间：
2012
影响因子：
4.2
通讯作者：
Fink JC
中科院分区：
文献类型：
--
作者：
Patel K;Diamantidis C;Zhan M;Hsu VD;Walker LD;Gardner J;Weir MR;Fink JC
非甾体抗炎药（NSAIDs），包括环氧化酶-2 （COX-2）抑制剂，通常是慢性肾脏疾病（CKD）的禁忌症。本研究旨在确定非甾体抗炎药/COX2处方的频率，并确定血清Cr与估计GFR对这种做法模式的影响。对一个已建立的退伍军人健康管理局（VHA） CKD安全性队列（n = 70154）进行了检查，以确定2005财政年度（FY05） NSAID/COX2在指数住院前最多30天以及该年度最多365天的频率。采用二项回归法确定NSAID/COX2处方与连续eGFR测量和血清肌酐（Cr）类别相关的调整患病率。CKD定义为eGFR < 60 ml/min/1.73m2。15.4%的受试者在观察期间使用了NSAID/COX2处方，随着肾功能的下降，使用这些药物的比例下降，但考虑到这些药物对肾脏的损害，在CKD的任何阶段仍然显著。在特定GFR估计中，血清肌酐（Cr）仍然是NSAID/COX处方的重要预测因子。当GFR为42 ml/min/1.73时，处方NSAID/COX2的预测比例为0.29 (95% CI: 0.24,0.36)；0.23 (95% ci: 0.22,0.26)；0.20 (95%: 0.19,0,22)；Cr≤1.3 mg/dl、1.4 ~ 1.6 mg/dl、1.7 ~ 2.1 mg/dl、≥2.2 mg/dl时，分别为0.12 (95% CI: 0.10,0.14) （p均< 0.05）。很大比例的CKD患者继续服用NSAID/COX2，血清Cr仍然是NSAID/COX2处方的重要指南，即使在GFR范围内，这些药物是不明智的。
Non-steroidal anti-inflammatory drugs (NSAIDs), including cyclo-oxygenase-2 (COX-2) inhibitors, are generally contraindicated in chronic kidney disease (CKD). This investigation sought to identify the frequency of NSAID/COX2 prescription and determine the influence of serum Cr versus estimated GFR on this practice pattern. An established Veterans Health Administration (VHA) CKD safety cohort (n = 70,154) was examined to determine the frequency of NSAID/COX2 in fiscal year 2005 (FY05) for up to 30 days preceding the index hospitalization and as many as 365 days during that year. Binomial regression was used to determine adjusted prevalence ratios for prescription of NSAID/COX2 with respect to continuous eGFR measurement and serum creatinine (Cr) categories. CKD was defined as eGFR < 60 ml/min/1.73m2. 15.4% of subjects had an NSAID/COX2 prescription during the observation period with the proportion prescribed these agents decreasing with declining renal function, but remained significant at any stage of CKD given the renal harm related to these medications. At specific GFR estimates, serum creatinine (Cr) remained a significant predictor of NSAID/COX prescription. At GFR set at 42 ml/min/1.73, the predicted proportion prescribed NSAID/COX2 was 0.29 (95% CI: 0.24,0.36); 0.23 (95% CI: 0.22,0.26); 0.20 (95%: 0.19,0,22); 0.12 (95% CI: 0.10,0.14) for Cr strata of ≤ 1.3 mg/dl, 1.4 – 1.6 mg/dl, 1.7 –2.1 mg/dl, ≥ 2.2 mg/dl, respectively (all p < 0.05). A significant proportion of individuals with CKD continue to be prescribed NSAID/COX2 and serum Cr remains an influential guide to NSAID/COX2 prescription, even in GFR ranges where these agents are ill-advised.
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影响因子：
2.3
作者：
Greer RC;Powe NR;Jaar BG;Troll MU;Boulware LE
通讯作者：
Boulware LE
影响因子：
120.7
作者：
Chertow, GM;Lee, J;Bates, DW
通讯作者：
Bates, DW
DOI：
10.1053/j.ajkd.2008.05.023
发表时间：
2008-10
期刊：
American journal of kidney diseases : the official journal of the National Kidney Foundation
影响因子：
--
作者：
Accetta NA;Gladstone EH;DiSogra C;Wright EC;Briggs M;Narva AS
通讯作者：
Narva AS
DOI：
10.1197/jamia.m1727
发表时间：
2005-05-01
影响因子：
6.4
作者：
Galanter, WL;Didomenico, RJ;Polikaitis, A
通讯作者：
Polikaitis, A
影响因子：
15.8
作者：
Steele, AW;Eisert, S;Ortiz, E
通讯作者：
Ortiz, E