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Percentage of U.S. Adults Using Prescribed NSAIDs

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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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.

FieldData
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 0.993**age 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.


eGFR Formula Disclaimer
At the time of the last data update in summer 2022, the race-free eGFR formula was newly recommended and impact on health outcomes is underway. To avoid inconsistent results caused by different formulae, stakeholders continued using the eGFR formula with race during this transition. Since then, comparisons have been made. The estimates for the current website launch are still based on analyses using the eGFR formula with race, however plan is to use race-free eGFR formula for the next data update and upcoming website launch in fall 2023.