男性における鎮痛剤の使用と腎機能
K M Rexrode1, J E Buring, R J Glynn
1Division of Preventive Medicine, Brigham and Women's Hospital, 900 Commonwealth Ave, Boston, MA 02215, USA. gaziano@maveric.org
JAMA
|July 24, 2001
まとめ
アセトアミノフェンやアスピリンなどの一般的な鎮痛剤の適度な使用は,健康な男性における腎臓疾患のリスクの増加と関連していない. この大規模な研究では,鎮痛薬の使用と腎臓機能不全との間に有意な関連性が見つかりませんでした.
科学分野:
- ネフロロジーは腎臓科
- エピデミオロジー エピデミオロジー
- 薬理学 薬理学とは
背景:
- 症例対照研究では,鎮痛剤の使用と慢性腎臓病との関連が示唆されています.
- しかし,この関連性を調査する堅実なコホート研究は限られている.
研究 の 目的:
- 鎮痛剤の摂取と腎臓機能障害を発症するリスクとの関連を調査する.
- この研究は,一般的な鎮痛剤が腎臓の健康に与える影響を明らかにすることを目的とした.
主な方法:
- Physicians' Health Study (医師の健康調査) の最初は健康な男性11,032人を対象とした14年間のコホート研究.
- 鎮痛剤 (アセトアミノフェン,アスピリン,NSAID) の使用は自己報告され,クレアチニンの上昇またはクレアチニンのクリアランスの低下によって定義される腎機能不全がありました.
- 様々な健康とライフスタイル要因に調整された多変量分析.
主要な成果:
- アセトアミノフェン,アスピリン,または他の非ステロイド性抗炎症薬 (NSAIDs) の使用とクレアチニン濃度の上昇との間に有意な関連性が見つかりませんでした.
- 同様に,クレアチニンクリアランスの低下は,鎮痛剤の使用と有意な関連性を示さなかった.
- 鎮痛剤の累積摂取量が高くても,腎臓機能不全のリスクの増加と相関関係はありませんでした.
結論:
- アセトアミノフェン,アスピリン,およびNSAIDを含む一般的な鎮痛剤の適度な使用は,当初健康な男性において腎機能不全のリスクを増加させるようには見えません.
- 発見は,典型的な鎮痛剤の消費が,この集団における腎臓機能に安全である可能性があることを示唆しています.
関連する概念動画
Factors Affecting Renal Clearance: Renal Impairment
588
Renal dysfunction significantly impairs the renal clearance of drugs, leading to potential complications in drug therapy. Renal failure, which can be caused by various factors, poses a significant challenge in the elimination of drugs from the body.
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
588
Renal Failure: Dose Adjustments
675
In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
675
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion
358
In geriatric patients, renal physiology undergoes significant changes, including diminished renal blood flow and a lower glomerular filtration rate (GFR), leading to alterations in medication clearance. Drugs such as aminoglycoside antibiotics, lithium, and digoxin, which rely on glomerular filtration for removal from the body, particularly impact pharmacokinetics. These drugs tend to have slower clearance rates in older adults, necessitating careful dosage considerations.Evaluation of renal...
358
Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant
374
In patients with renal disease, dosage adjustments are necessary to maintain therapeutic plasma drug concentrations and prevent toxicity or subtherapeutic exposure. Renal impairment alters drug pharmacokinetics, especially in conditions like uremia, where changes such as prolonged elimination half-life and altered apparent volume of distribution can significantly affect drug disposition. These changes require careful modification of the dosing regimen to achieve the desired clinical...
374
Urinary Tract Calculi III: Medical Management
402
The diagnosis of renal calculi involves several imaging techniques, including non-contrast CT scans and ultrasound. These methods help visualize kidney stones, assess their size and location, and detect possible obstructions. Additionally, Measuring urine pH is useful for diagnosing specific stone types, such as struvite (alkaline pH) and uric acid stones (acidic pH). Cystine stones are primarily linked to cystinuria, a genetic condition. A urinalysis helps detect blood in the urine (hematuria)...
402
Acute Kidney Injury IV: Diagnostic Studies and Prevention
582
Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
582


