Associations between analgesia, dose and eGFR decline
| Drug | Dose category | Normal or Mildly impaired eGFR* (n=3452) | Dose category | Stage 3–5 CKD† (n=661) | ||
|---|---|---|---|---|---|---|
| Unadjusted OR (95% CI) | Adjusted OR (95% CI)‡ | Unadjusted OR (95% CI) | Adjusted OR (95% CI)‡ | |||
| NSAIDs | Non-user (n=2821) | 1.00 | 1.00 | Non-user (n=581) | 1.00 | 1.00 |
| Normal dose user (n=536) | 0.86 (0.70 to 1.07) | 1.02 (0.82 to 1.27) | Normal dose user (n=69) | 0.94 (0.51 to 1.71) | 1.01 (0.54 to 1.87) | |
| High dose user (n=95) | 0.73 (0.45 to 1.20) | 0.88 (0.53 to 1.46) | High dose user (n=11) | 0.34 (0.04 to 2.66) | 0.44 (0.05 to 3.55) | |
| Aspirin | Non-user (n=2169) | 1.00 | 1.00 | Non-user (n=349) | 1.00 | 1.00 |
| Normal dose user (n=1110) | 1.13 (0.94 to 1.33) | 0.96 (0.81 to 1.14) | Normal dose user (n=264) | 0.96 (0.65 to 1.41) | 0.86 (0.57 to 1.30) | |
| High dose user (n=173) | 0.64§ (0.43 to 0.95) | 0.52§ (0.35 to 0.77) | High dose user (n=48) | 1.43 (0.73 to 2.80) | 1.22 (0.61 to 2.47) | |
| Paracetamol | Non-user (n=2578) | 1.00 | 1.00 | Non-user (n=452) | 1.00 | 1.00 |
| Normal dose user (n=584) | 0.98 (0.80 to 1.20) | 0.85 (0.69 to 1.05) | Normal dose user (n=169) | 0.98 (0.64 to 1.50) | 0.92 (0.60 to 1.42) | |
| High dose user (n=110) | 1.09 (0.72 to 1.66) | 0.98 (0.64 to 1.51) | High dose user (n=40) | 0.85 (0.40 to 1.90) | 0.81 (0.36 to 1.85) | |
1.00=Reference group in each category. *26 patients with an estimated glomerular filtration rate ≥60.
†6 patients with an estimated glomerular filtration rate <60 did not have an IMD score and are not included in this analysis.
‡Adjusted for age (continuous), gender, deprivation quartile, diabetes mellitus, chronic kidney disease, RAS-i prescribing, other analgesia use (either aspirin or paracetamol in the case of non-steroidal anti-inflammatory drugs users) and baseline chronic kidney disease status.
§Significant result.