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Percentage of U.S. Adults Using Prescribed NSAIDs

NSAID (non-steroidal anti-inflammatory drug) use was much lower after 2001–2004 in U.S. adults. Use of any NSAID is higher among adults with chronic kidney disease (CKD) stages 3–5 (9.2%) than with CKD stages 1–2 (6.1%) and those without CKD (5.9%) during 2017–March 2020.

Data Source: NHANES

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Percentage of U.S. Adults Using Prescribed NSAIDs by Overall and CKD Stage National Health and Nutrition Examination Survey
CKD Stage	2001-2004	2005-2008	2009-2012	2013-2016	2017-2020
No CKD	9.1 (CI 8.1-10.2)	5.3 (CI 4.4-6.1)	4.6 (CI 4.0-5.3)	5.4 (CI 4.7-6.1)	5.9 (CI 5.1-6.7)
CKD Stages 1 & 2	10.9 (CI 7.9-13.8)	8.4 (CI 5.8-11.1)	5.6 (CI 3.5-7.7)	8.2 (CI 5.4-11.0)	6.1 (CI 4.4-7.9)
CKD Stages 3–5	16.7 (CI 14.2-19.2)	9.8 (CI 7.5-12.2)	9.3 (CI 5.3-13.3)	8.6 (CI 6.3-10.9)	9.2 (CI 6.5-11.8)
All Stages Combined	13.5 (CI 11.5-15.4)	9.1 (CI 7.1-11.0)	7.4 (CI 5.2-9.6)	8.4 (CI 6.8-9.9)	7.5 (CI 5.8-9.1)

Data includes CKD stages 1–5. Data are not adjusted.

NHANES is a nationally representative, cross-sectional survey that is currently conducted every two years (since 1999) by CDC's National Center for Health Statistics among noninstitutionalized US civilian residents. The survey consists of a standardized in-home interview and a physical examination with blood and urine collected at a mobile examination center.

Data were examined by combining two NHANES cycles to represent four-year periods from 2001 to 2016 and the 2017–March 2020 pre-pandemic cycle.

Field	Data
Description of Measure	Use of prescribed NSAIDs by CKD stage in the U.S. population.
Data Set	National Health and Nutrition Examination Survey (NHANES).
Population	Noninstitutionalized U.S. adults aged ≥ 18 years, excludes pregnant women.
Years Included	2001–March 2020.
Numerator	Adults aged ≥ 18 years who were prescribed NSAIDs.
Denominator	Adults aged ≥ 18 years with albuminuria and serum creatinine measurements.
Definition of CKD and CKD Stage	CKD is defined by estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m² or albuminuria (urine albumin to creatinine ratio [UACR] ≥ 30 mg/g). Stage 1: eGFR ≥ 90 ml/min/1.73 m² and albuminuria; stage 2: eGFR 60–89 ml/min/1.73 m² and albuminuria; stage 3: eGFR 30–59 ml/min/1.73 m²; stage 4: 15–29 ml/min/1.73 m²; stage 5: eGFR < 15 ml/min/1.73 m². Estimates are based on single estimates of eGFR and UACR.
Estimated glomerular filtration rate (eGFR)	Based on the CKD-EPI equation for calibrated creatinine: eGFR=141 x [min(serum creatinine in mg/dL) /κ, 1)]α x [max(serum creatinine/κ, 1)]-1.20 x 0.993age x (1.018 if female) x (1.159 if a Black person). κ = 0.7 if female and 0.9 if male α = -0.329 if female and -0.411 if male = raise to the power
Albuminuria	UACR is calculated as urine albumin divided by urine creatinine. Albuminuria is defined as UACR ≥ 30 mg/g.
Serum Creatinine	Serum creatinine values used for eGFR calculation are standardized against isotope dilution mass spectrometry (IDMS).
Urine Albumin	Measured in random urine collection by fluorescent immunoassay.
Non-steroidal anti-inflammatory drugs (NSAIDs)	NSAIDs are defined by the medication’s generic name from the prescription medication data files. The following drugs are included: Ibuprofen, celecoxib, choline, diclofenac, diflunisal, etodolac, fenoprofen, flurbiprofen, indomethacin, ketoprofen, ketorolac, meclofenamate, mefenamic acid, meloxicam, nabumetone, naproxen, nimesulide, oxaprozin, pentoxifylline, pilocarpine, piroxicam, rofecoxib, salsalate, sulindac, tiaprofenic acid, tolmetin, and valdecoxib.
Limitations of Indicator	Prevalence of self-reported NSAID use does not include over-the-counter medication use, which may not reflect overall use of NSAIDs in the adult population.
Analytical Considerations	Appropriate NHANES survey weights are used for all analyses; if relative standard error is greater than 30%, the estimates are not shown. Serum creatinine measurements are assay corrected for NHANES years 2005 and 2006 and prior to be combined with later years.