- High NSAID exposure is tied to increased risks for acute kidney injury (AKI) and chronic kidney disease (CKD) among active younger and middle-aged adults.
Why this matters
- Lower doses may be beneficial for civilians with strenuous, potentially dehydration-producing occupations.
- Retrospective study of 764,228 active-duty US Army soldiers (mean age, 28.6±7.9 years; 85.8% men) serving between 2011 and 2014; analysis conducted in 2018.
- Funding: National Heart, Lung, and Blood Institute; Uniformed Services University of the Health Sciences.
- 17.9% were dispensed 1-7 mean total defined daily doses (DDD) monthly.
- 16.3% received >7 DDD/month.
- Over a median 2.4 person-years, 0.3% developed AKI and 0.2% developed CKD.
- NSAID exposure >7 DDD/month (vs none) was tied to a 20% increased risk for AKI (aHR=1.2; 95% CI, 1.1-1.4) and CKD (aHR=1.2; 95% CI, 1.0-1.3).
- 17.6 and 30.0 excess AKI and CKD cases, respectively, per 100,000 persons/year.
- Compared with whites, African-Americans had higher risks for AKI (aHR=1.6; 95% CI, 1.4-1.7) and CKD (aHR=2.3; 95% CI, 2.0-2.5).
- Male sex was tied to increased risks for AKI (aHR=2.3; 95% CI, 2.0-2.7) and CKD (aHR=1.6; 95% CI, 1.4-1.9).
- Risk increased with age >22 years, particularly for CKD.
- Reliance on diagnostic codes.
- Over-the-counter use not captured.
- Population prone to intermittent dehydration.