Pain drugs may raise risk of kidney failure

The use of nonsteroidal antiinflammatory drugs (“NSAID”), which include pain relievers like ibuprofen (Motrin, Advil) may increase the risk of kidney failure, according to a report in the American Journal of Epidemiology.

“NSAIDs are associated not uncommonly with renal failure,” Dr. James M. Brophy from McGill University in Montreal told Reuters Health. “This rate of renal failure is approximately twice that observed for (heart attack). Clinicians should, therefore, be concerned not only about cardiac but also renal adverse effects and, therefore, restrict NSAID use only for those situations where the benefit is expected to outweigh the risks.”

Brophy and colleagues investigated the association of NSAID use with kidney failure in elderly patients. The study included 4228 people with kidney failure and 84,540 similar subjects without kidney failure.

Current new users of any NSAID had a risk of kidney failure twice that of nonusers, the investigators found.

The risk of renal failure was not elevated among individuals who had recently stopped using NSAIDs, the researchers note, and was actually lower among past NSAID users than among people who had never used these drugs.

“I think physicians should use the lowest possible dose of all NSAIDs for the shortest possible period of time,” Brophy said. “Also, since the risk is highest with current new users, it would seem appropriate to check (kidney) function shortly after debuting therapy—perhaps 2 weeks.”

However, data from trials involving an inactive “placebo” comparison group are needed to confirm the current findings, he added.

SOURCE: American Journal of Epidemiology, November 1, 2006.

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