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NSAIDs AND KIDNEY FAILURE.

Nonsteroidal anti-inflammatory drugs (NSAIDs) are known to be nephrotoxic and may be associated with acute renal failure (ARF). A population-based, case-control study in Saskatchewan assessed this association by comparing NSAID use in 28 cases of idiopathic ARF and 1997 matched controls identified from a provincial database.

The crude incidence rate of hospitalization for ARF among nonusers of NSAIDs was 1.7 per 100,000 person-years. The greatest risk factor for ARF was recent hospitalization for other disorders (odds ratio, 6.9), and the next strongest risk factor was current NSAID use (OR, 4.1). The relationship between NSAID use and risk of ARF was dose-dependent, with an odds ratio of 9.8 for high-dose use and 4.0 for low-dose use. The risk reverted to baseline when NSAIDs were stopped.

Comment: The risk of ARF associated with NSAID use is the same as with other nephrotoxic drugs, such as the aminoglycosides. NSAID use should be considered in the evaluation of patients admitted for ARF.

— TL Schwenk

Published in Journal Watch General Medicine December 17, 1996

Citation(s):

Gutthann SP et al. Nonsteroidal anti-inflammatory drugs and the risk of hospitalization for acute renal failure. Arch Intern Med 1996 Nov 25 156 2433-2439.

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