Association of Analgesic Use With Prevalence of Albuminuria and Reduced GFR in US Adults
Received 23 May 2007; accepted 11 December 2007. published online 04 March 2008.
Background
Prolonged analgesic consumption may adversely affect kidney function. The relation of long-term analgesic use to markers of decreased kidney function has not been investigated in the general population.
Design
Cross-sectional analysis.
Setting
National Health and Nutrition Examination Survey conducted in 1999-2002.
Participants
Noninstitutionalized residents at least 20 years old (n = 8,057, representing 177.8 million adults).
Predictors
Ever intake of an analgesic every day for at least a month defined habitual analgesic use, classified by product (aspirin, acetaminophen, ibuprofen, and selected prescription drugs) and years of use (<1, 1 to 5, and >5 years).
Outcomes
Albuminuria in random urine (albumin-creatinine ratio ≥ 30 mg/g; n = 1,088) and reduced estimated glomerular filtration rate (eGFR; <60 mL/min/1.73 m2, n = 852) using the Modification of Diet in Renal Disease Study equation and the composite of either.
Measurements
Age-standardized prevalence in habitual analgesic users and non–habitual analgesic users and multivariable-adjusted odds ratios (ORs).
Results
In US adults, 23.7% (95% confidence interval [CI], 21.7 to 25.6) reported habitual analgesic use. Multivariable-adjusted ORs for reduced eGFR prevalence in adults with habitual analgesic use of acetaminophen only, ibuprofen only, and aspirin only were 1.03 (95% CI, 0.6 to 1.7), 1.21 (95% CI, 0.7 to 2.1), and 0.95 (95% CI, 0.7 to 1.2) compared with non–habitual analgesic use, respectively. Corresponding ORs for prevalent albuminuria were 0.93 (95% CI, 0.7 to 1.3), 0.65 (95% CI, 0.4 to 1.2), and 0.86 (95% CI, 0.6 to 1.2). Association measures had intermediate levels for the composite marker of decreased kidney function and were not significant. No association between prevalent outcomes and habitual analgesic exposure duration of 5 years or longer or multiple product habitual analgesic consumption was observed.
Limitations
Reliability of self-reported analgesic use behavior was not assessed.
Conclusions
Habitual analgesic use of single or multiple products was not associated with increased prevalence of albuminuria or reduced eGFR.
1Division of Kidney, Urologic, and Hematologic Disorders, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD
2Social & Scientific Systems Inc., Silver Spring, MD.
Address correspondence to Lawrence Y. Agodoa, MD, National Institute of Diabetes and Digestive and Kidney Diseases, 6707 Democracy Blvd, Rm 611, Bethesda, MD 20892-5458.
ABSTRACT