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Use of non‐steroidal anti‐inflammatory drugs and risk of chronic kidney disease in people with Type 2 diabetes mellitus, a nationwide longitudinal cohort study
Author(s) -
Tsai H.J.,
Hsu Y.H.,
Huang Y.W.,
Chang Y.K.,
Liu J.S.,
Hsu C.C.
Publication year - 2015
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/dme.12610
Subject(s) - medicine , kidney disease , diabetes mellitus , aspirin , hazard ratio , type 2 diabetes , drug , cohort study , disease , population , cohort , pharmacology , endocrinology , confidence interval , environmental health
Aims To investigate the temporal relationship between non‐steroidal anti‐inflammatory drug use and the development of chronic kidney disease in people with Type 2 diabetes mellitus. Methods We conducted a retrospective cohort study and followed up a population with Type 2 diabetes who were chronic kidney disease‐free ( n = 48 715) using national health insurance claims data in Taiwan. Exposure status to non‐steroidal anti‐inflammatory drugs in 2007 was measured. A total of 6406 subjects with incident chronic kidney disease were identified from the period 2008 to 2011. Multivariable proportional hazards models were applied to determine the temporal relationship between non‐steroidal anti‐inflammatory drug use and the development of chronic kidney disease. Results We observed a significant temporal relationship between non‐steroidal anti‐inflammatory drug use and the development of chronic kidney disease in people with Type 2 diabetes. Compared with people not taking any non‐steroidal anti‐inflammatory drug in 2007, those who were taking such drugs for at least 90 days in 2007 had a higher risk of chronic kidney disease development (adjusted hazard ratio 1.37, 95% CI 1.26–1.49). In subgroup analyses, those people (irrespective of age, sex, various comorbidities and use of anti‐hypertensive drugs, aspirin or acetaminophen) who were taking non‐steroidal anti‐inflammatory drugs for at least 90 days were more likely to develop chronic kidney disease than people who were not taking any non‐steroidal anti‐inflammatory drug. Conclusions The results suggest that there is a positive temporal relationship between non‐steroidal anti‐inflammatory drug use and increased risk of chronic kidney disease in people with Type 2 diabetes. The use of non‐steroidal anti‐inflammatory drugs should be based on clinical evaluations of benefits and risks, and should be prescribed with caution for people with Type 2 diabetes.