TY - JOUR
T1 - Association between NSAID use and mortality risk in patients with end-stage renal disease
T2 - A population-based cohort study
AU - Lai, Ka Man
AU - Chen, Ta Liang
AU - Chang, Chuen Chau
AU - Chen, Hsi Hsien
AU - Lee, Yuan Wen
N1 - Publisher Copyright:
© 2019 Lai et al.
PY - 2019/1/1
Y1 - 2019/1/1
N2 - Background: Pain is one of the most common symptoms experienced by patients with endstage renal disease. Although NSAIDs may lead to adverse events, NSAID use appears to be considerably high in patients with end-stage renal disease. However, whether NSAID use is associated with an increased risk of mortality in this population remains unknown. Aim: This study aimed to investigate the association between the use of NSAIDs and the risk of mortality in patients with end-stage renal disease. Patients and methods: We used the population-based Taiwan National Health Insurance Research Database to investigate the association between the use of NSAIDs and the risk of mortality in patients with end-stage renal disease receiving dialysis. A total of 3,383 patients with newly diagnosed end-stage renal disease requiring long-term dialysis between 1998 and 2012 were included in the current study, and the study outcome was evaluated until December 31, 2013. Time-dependent Cox regression models were applied to examine the association between NSAID use and mortality risk. Results: In the study cohort, 2,623 (78%) patients used NSAIDs during the follow-up period. The median follow-up period was 4.0 years, during which 1,515 patients died. The results of multivariable analysis demonstrated that compared with NSAID nonuse, the use of any NSAIDs, nonselective NSAIDs, and selective cyclooxygenase-2 inhibitors was associated with a significantly increased risk of all-cause mortality with an adjusted HR (95% CI) of 1.39 (1.21-1.60), 1.36 (1.19-1.55), and 1.61 (1.42-1.83), respectively. Conclusion: The results suggest that NSAID use was associated with an increased risk of mortality in the patients with end-stage renal disease. Future randomized controlled trials are needed to validate these observational findings.
AB - Background: Pain is one of the most common symptoms experienced by patients with endstage renal disease. Although NSAIDs may lead to adverse events, NSAID use appears to be considerably high in patients with end-stage renal disease. However, whether NSAID use is associated with an increased risk of mortality in this population remains unknown. Aim: This study aimed to investigate the association between the use of NSAIDs and the risk of mortality in patients with end-stage renal disease. Patients and methods: We used the population-based Taiwan National Health Insurance Research Database to investigate the association between the use of NSAIDs and the risk of mortality in patients with end-stage renal disease receiving dialysis. A total of 3,383 patients with newly diagnosed end-stage renal disease requiring long-term dialysis between 1998 and 2012 were included in the current study, and the study outcome was evaluated until December 31, 2013. Time-dependent Cox regression models were applied to examine the association between NSAID use and mortality risk. Results: In the study cohort, 2,623 (78%) patients used NSAIDs during the follow-up period. The median follow-up period was 4.0 years, during which 1,515 patients died. The results of multivariable analysis demonstrated that compared with NSAID nonuse, the use of any NSAIDs, nonselective NSAIDs, and selective cyclooxygenase-2 inhibitors was associated with a significantly increased risk of all-cause mortality with an adjusted HR (95% CI) of 1.39 (1.21-1.60), 1.36 (1.19-1.55), and 1.61 (1.42-1.83), respectively. Conclusion: The results suggest that NSAID use was associated with an increased risk of mortality in the patients with end-stage renal disease. Future randomized controlled trials are needed to validate these observational findings.
KW - End-stage renal disease
KW - Mortality
KW - NSAIDs
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U2 - 10.2147/CLEP.S204322
DO - 10.2147/CLEP.S204322
M3 - Article
AN - SCOPUS:85071071227
SN - 1179-1349
VL - 11
SP - 429
EP - 441
JO - Clinical Epidemiology
JF - Clinical Epidemiology
ER -