Original investigation: pathogenesis and treatment of kidney disease and hypertensionAnalgesic use and change in kidney function in apparently healthy men1
Section snippets
Methods
Study subjects were participants in the PHS, a completed randomized trial of aspirin and beta carotene in the primary prevention of cardiovascular disease and cancer. The design and methods of the PHS have been described in detail previously.23, 24, 25 The PHS included 22,071 apparently healthy male physicians without history of cardiovascular disease, cancer (except nonmelanoma skin cancer), current liver disease or kidney dysfunction (defined as kidney failure or insufficiency), or other
Results
Among 4,494 men with creatinine measurements in 1982 and 1996 and no history of kidney failure or kidney insufficiency at baseline or during follow-up, an increase in plasma creatinine level (≥0.3 mg/dL [≥26.5 μmol/L]) was noted in 242 participants (5.4%) and a decrease in GFR (≥29 mL/min/1.73 m2) was noted in 224 participants (5%; Table 1). Men with increased creatinine levels were significantly older, had decreased HDL levels, were more likely to be hypertensive, had greater rates of
Discussion
In this study of apparently healthy men at baseline, we evaluated analgesic use and change in kidney function during a 14-year period and found no evidence of a decline in kidney function, assessed by either a plasma creatinine level elevation of 0.3 mg/dL or greater (≥26.5 μmol/L) or a GFR reduction of 29 mL/min/1.73 m2 or greater, with increasing analgesic intake of any kind. Use of 2,500 analgesic pills or more during the 14-year study period (3 to 4 pills/wk) did not increase the risk for
Acknowledgements
The authors thank the participants in the PHS for their outstanding commitment and cooperation; the entire PHS staff for their expert and unfailing assistance; Vadim Bubes, PhD, for programming support; and Patrick J. Skerrett, MA, for assistance in editing the manuscript.
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2020, American Journal of Kidney DiseasesAssociation of Opioids and Nonsteroidal Anti-inflammatory Drugs With Outcomes in CKD: Findings From the CRIC (Chronic Renal Insufficiency Cohort) Study
2020, American Journal of Kidney DiseasesCitation Excerpt :However, epidemiologic studies examining analgesics and kidney failure have revealed mixed findings.23,26 The Physician Health Study showed no risk for decreased GFRs among moderate users of aspirin, acetaminophen, or NSAIDs.27,28 Several case-control studies found that substantial consumption of acetaminophen, aspirin, and NSAIDs was associated with increased risk for kidney failure.29,30
Nonsteroidal Antiinflammatory Drugs and Opioids in Chronic Kidney Disease
2019, Chronic Renal DiseaseEffect of aspirin on renal disease progression in patients with type 2 diabetes: A multicenter, double-blind, placebo-controlled, randomized trial. The renaL disEase progression by aspirin in diabetic pAtients (LEDA) trial. Rationale and study design
2017, American Heart JournalCitation Excerpt :To date, however, the data available in the literature on the long-term effects of low-dose aspirin (or other antiplatelet agents) on kidney function and progression of CKD in humans are scarce and inconclusive. In a prospective cohort study of 4,494 US male physicians, aspirin intake significantly reduced the risk for decline in kidney function compared with those who never use it in the group of subjects without cardiovascular risk factors.25 In a study including 14 patients with severe congestive heart failure, the administration of picotamide, which is a TxA2 synthase and TxA2/prostaglandin H2 receptor inhibitor, resulted in an improvement in effective renal plasma flow and eGFR.26
Non-Steroidal Anti-Inflammatory Drugs and Chronic Kidney Disease
2015, Chronic Renal Disease
Supported in part by grants no. CA 34944 and CA 40360 from the National Cancer Institute; grants no. HL 26490 and HL 34595 from the National Heart, Lung, and Blood Institute, Bethesda, MD; and a grant from McNeil Consumer Products.
- 1
The sponsor of the study had no role in study design, data collection, data analysis, data interpretation, or the writing of the manuscript.
- 2
Dr. Glynn received consulting fees from AstraZeneca and grant support from Bristol-Meyers Squibb.
- 3
Dr. Walker is employed by Ingenix, Auburndale, MA. United Health Group owns both Ingenix and UnitedHealth Care. UnitedHealth Care, as an insurer, has a financial interest in cost-effective reduction of kidney disease risk. At various times, he has conducted research sponsored by most manufacturers of NSAIDs.
- 4
Dr.Hennekens received research grant support from Bayer and PharMed. He serves as a consultant, including Chair or Membership on Data and Safety Monitoring Boards, to AstraZeneca, Bayer, Bristol-Myers Squibb, Chattem, GlaxoSmith Kline, McNeil, Novartis, Pfizer, and Reliant. He is a co-inventor on patents concerning inflammatory markers and cardiovascular disease, which are held by Brigham and Women's Hospital.
- 5
Dr. Gaziano received research funds from BASF, McNeil, Roche, and Wyeth. During 2002 and 2003, he also served as a consultant to McNeil and Wyeth.