In 1999-2004, 8.0-8.1% of U.S. adults with mild to severe CKD reported ever chronically using NSAIDs (30 days or more), which was not substantially different from than the percentage of adults without CKD reporting chronic NSAID use (8.5%).
Chart Explanation: Over the entire 6-year period, 8.0% and 8.1% of those with mild and moderate to severe CKD, respectively, reported using NSAIDs chronically (30+ days), compared to 8.5% of those without CKD. Those with CKD were less likely than those without to use ibuprofen chronically, but more likely to use naproxen (not statistically significant). NSAIDs other than ibuprofen and naproxen were reported to be chronically used by <1% of participants and frequency did not differ by CKD status (data not shown).
The NHANES (National Health and Nutrition Examination Survey) is a nationally representative, cross-sectional survey that is currently conducted every 2 years by the National Center for Health Statistics to examine disease prevalence and trends over time in non-institutionalized U.S. civilian residents.
Non-steroidal anti-inflammatory drugs (NSAIDs) are widely available both as over-the-counter and prescription pain relievers, but are relatively contra-indicated in persons with CKD due to their nephrotoxic effects. The survey consists of a standardized in-home interview and a physical examination and blood and urine collection at a mobile examination center (MEC). Here we examined data from a survey on analgesic use conducted during the 1999-2000, 2001-2002, and 2003-2004 NHANES. Chronic use was defined as ever using a NSAID for 30 days or more. NSAIDs included ibuprofen, naproxen, sulindac, piroxicam, indomethacin, tolmetin, and diclofenac; aspirin and acetaminophen were considered relatively non-nephrotoxic and were excluded from analysis.
|Description of Measure||Prevalence of NSAID use among persons with and without CKD in the general population|
|Type of Data Source||Public|
|Health Care System Data||No|
|Regional or National?||National|
|Demographic Group||Non-institutionalized U.S. residents aged 20+|
|Numerator||Non-pregnant adult participants with data on albuminuria and creatinine who reported chronically using NSAIDs|
|Denominator||Non-pregnant adult participants with data on albuminuria and creatinine who completed an analgesic survey|
|Primary Data Source Indicator||rxq300: “Have you ever taken any analgesic (list shown), including combination products, for 30 days or more?” yes/no|
|Primary Indicator Method of Measurement||Questionnaire (interviewer-administered); ages 1+|
|Secondary (1) Variable||lbxscr: Serum creatinine|
|Secondary (1) Indicator Method of Measurement||Examination/Laboratory|
|Secondary (2) Variable||rhd143, rhd141/rhd140, urxpreg: current pregnancy|
|Secondary (2) Indicator Method of Measurement||Questionnaire (interviewer-administered) or exam (urine pregnancy status)|
|Secondary (3) Variable||urxcua/urxucr: urinary proteins|
|Secondary (3) Indicator Method of Measurement||Examination/laboratory|
|Frequency of Measurement (Primary)||Once (cross-sectional)|
|U.S. Region Covered by Primary Variable||All|
|Period Currently Available||1999–2004|
|Pending Data||— (analgesic survey discontinued)|
|Additional Data Items of Interest||Stage of CKD, type of NSAID|
|Limitations of Indicator||Self-reported use (may be underestimated); not all available analgesics included in survey; cross-sectional|
|Analytical Considerations||Appropriate NHANES survey weights must be used for all analyses|
References and Sources:
Plantinga, L, Grubbs, V, Sarkar, U, et al. Nonsteroidal Anti-inflammatory Drug Use Among Persons With Chronic Kidney disease in the United States. The Annals of Family Medicine. 2011;9(5):423-430.