Journal
DIABETIC MEDICINE
Volume 32, Issue 3, Pages 382-390Publisher
WILEY-BLACKWELL
DOI: 10.1111/dme.12610
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Funding
- National Health Research Institutes, Taiwan [PH-099-PP-56, PH-101-SP-14, PH-102-SP-05]
- National Science Council, Taiwan [NSC 101-2314-B-400-002]
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AimsTo 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. MethodsWe conducted a retrospective cohort study and followed up a population with Type 2 diabetes who were chronic kidney disease-free (n=48715) 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. ResultsWe 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 90days 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 90days were more likely to develop chronic kidney disease than people who were not taking any non-steroidal anti-inflammatory drug. ConclusionsThe 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. What's new?
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