慢性腎臓病患者の非ステロイド抗炎症薬による心不全のリスク: 系統的レビュー
Bethany S Ward1, Michael Naughton2, Dorothea Nitsch3
1Department of Population Health Sciences, School of Population Health and Environmental Sciences, Faculty of Life Sciences and Medicine, King's College London, 3.04, 3rd Floor Addison House, Guy's Campus, London, SE1 1UL UK.
Journal of public health (Berlin, Germany)
|August 29, 2025
まとめ
非ステロイド性抗炎症薬 (NSAIDs) は慢性腎臓病 (CKD) の患者に心不全のリスクを及ぼす可能性があります. しかし,現在の研究は限られており,この関連性を確認または否定する確固たる証拠はありません.
科学分野:
- 腎臓科
- 心臓病科
- 薬理学について
背景:
- 慢性腎臓病 (CKD) は腎臓の機能に影響し,心血管疾患のリスクを高める可能性があります.
- 非ステロイド性抗炎症薬 (NSAIDs) は,腎臓および心血管の副作用が知られている,一般的に使用される鎮痛剤です.
- 慢性腎臓病患者のNSAID使用と心不全 (HF) の相互作用は依然として懸念される分野です.
研究 の 目的:
- 慢性腎臓病 (CKD) と診断された患者のNSAID誘発性心不全 (HF) のリスクを体系的に検討し,検討する.
主な方法:
- Embase,Medline,CENTRAL,Web of Science,およびGoogle Scholar (1999-2020) で包括的な文献検索が行われました.
- 結末として,CKD,NSAID曝露,HFの被験者を対象とした研究が含まれています.
- Cochrane Risk of Bias 2とROBINS- Iツールを使用してバイアスのリスクを評価した.
主要な成果:
- 2480件の初期論文から7つの研究 (RCT2つ,コホート4つ,対照1つ) が特定された.
- CKD (ステージ3- 5) のHFの相対リスクは0. 3から1. 9 (95% CI 0. 04から15. 1) であった.
- 結果は集団における有意な研究異質性,混同要因,およびHFのアウトカム測定により,プールされませんでした.
結論:
- 慢性腎臓病患者のNSAIDによる心不全のリスクに関する研究は限られている.
- リスクの増大を断固として裏付ける 確固たる証拠は現時点では存在しない.
- 慢性腎臓病患者のNSAID使用と心不全との関連を明らかにするために,さらに質の高い研究が必要である.
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