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Indicator Details: Prevalence of NSAID Use Among Persons With and Without CKD in the General Populationa,b
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Published literature or one-time analysis, ongoing surveillance not available Published literature or one-time analysis, ongoing surveillance not available

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a Any NSAID, any of ibuprofen, naproxen, sulindac, piroxicam, indomethacin, tolmetin, and diclofenac excluding aspirin and acetaminophen; OTC NSAID, any NSAID available over-the-counter (ibuprofen and naproxen). P > 0.05 across CKD categories by χ².

b eGFR for this indicator was calculated using the isotope dilution mass spectrometry (IDMS)-traceable MDRD Study equation for calibrated creatinine. We are currently in the process of updating this indicator to instead use the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation.

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 MeasurePrevalence of NSAID use among persons with and without CKD in the general population
Data SourceNCHS
Type of Data SourcePublic
Health Care System DataNo
Regional or National?National
Demographic GroupNon-institutionalized U.S. residents aged 20+
NumeratorNon-pregnant adult participants with data on albuminuria and creatinine who reported chronically using NSAIDs
DenominatorNon-pregnant adult participants with data on albuminuria and creatinine who completed an analgesic survey
Primary Data Source Indicatorrxq300: “Have you ever taken any analgesic (list shown), including combination products, for 30 days or more?” yes/no
Primary Indicator Method of MeasurementQuestionnaire (interviewer-administered); ages 1+
Secondary (1) Variablelbxscr: Serum creatinine
Secondary (1) Indicator Method of MeasurementExamination/Laboratory
Secondary (2) Variablerhd143, rhd141/rhd140, urxpreg: current pregnancy
Secondary (2) Indicator Method of MeasurementQuestionnaire (interviewer-administered) or exam (urine pregnancy status)
Secondary (3) Variableurxcua/urxucr: urinary proteins
Secondary (3) Indicator Method of MeasurementExamination/laboratory
Frequency of Measurement (Primary)Once (cross-sectional)
U.S. Region Covered by Primary VariableAll
Period Currently Available1999–2004
Pending Data— (analgesic survey discontinued)
Additional Data Items of InterestStage of CKD, type of NSAID
Limitations of IndicatorSelf-reported use (may be underestimated); not all available analgesics included in survey; cross-sectional
Analytical ConsiderationsAppropriate 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.

Suggested Citation:
Centers for Disease Control and Prevention. Chronic Kidney Disease Surveillance System—United States.
website. http://www.cdc.gov/ckd