NSAIDs may not affect renal function in older patients
It is well established that long-term use of high doses of NSAIDs can cause kidney injury, especially in older adults. This association has been criticized, however, because it is based only on serum creatinine-based glomerular filtration rate (GFR) estimates. A recent study published in the March issue of the Journal of the American Geriatrics Society investigated the association of NSAID use with kidney damage in older adults using multiple kidney health measures.
The study involved 2,990 older adults in a multicenter, community-based cohort who self-reported prescription and OTC NSAID use. Baseline estimated GFR by cystatin C, urine albumin‐to‐creatinine ratio, kidney injury molecule‐1, and interleukin‐18 were measured in all participants. In addition, alpha‐1 microglobulin, neutrophil gelatinase‐associated lipocalin, propeptide type III procollagen, and uromodulin were measured in 500 participants. GFR was estimated three times over 10 years and expressed as percent change per year.
The researchers found that self‐reported NSAID use was not associated with kidney dysfunction or injury based on these multiple measures, raising the possibility of NSAID use without kidney harm in ambulatory older adults. They concluded that more research is needed to define safe patterns of NSAID use.
Loren Bonner, senior editor