Effects of NSAIDs on Early CKD Development: A 10-Year Population-Based Study Using the Korean Senior Cohort

Area of Science:

• Nephrology
• Geriatric Medicine
• Pharmacology

Background:

• Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly prescribed for pain relief in older adults.
• While acute NSAID nephrotoxicity is known, long-term renal effects in community-dwelling seniors remain unclear.
• This study addresses the association between NSAID use and chronic kidney disease (CKD) in the elderly population.

Purpose of the Study:

• To investigate the association between NSAID consumption and the risk of developing chronic kidney disease (CKD).
• To assess the impact of NSAID use on renal function decline in a senior population.

Main Methods:

• Analysis of data from the National Health Insurance Service-Senior Cohort (NHIS-SC) in South Korea.
• 1812 participants (604 NSAID users, 1208 controls) were propensity score matched.
• Kidney dysfunction defined as estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73m² with ≥ 10% decline; Cox regression used to estimate hazard ratios (HRs) for CKD.

Main Results:

• NSAID use was significantly associated with an increased risk of CKD (HR 1.46; 95% CI 1.11-1.93).
• NSAID users exhibited a faster decline in eGFR compared to controls.
• Both Cox-1 and Cox-2 inhibitors showed elevated CKD risks (HR 1.53 and HR 1.61, respectively); end-stage renal disease (ESRD) incidence was not significantly different.

Conclusions:

• NSAID use elevates CKD risk and accelerates kidney function decline in the elderly.
• Judicious NSAID prescription and consistent renal function monitoring are recommended for senior patients.
• Further randomized controlled trials are warranted to confirm these findings and guide clinical practice.