This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (29)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Renal Diseases, Other  • Women's Health  • Women's Health, Other  • Adverse Effects  • Alert me on articles by topic  Social Bookmarking   What's this?

Gary C. Curhan, MD, ScD; Eric L. Knight, MD, MPH; Bernard Rosner, PhD; Susan E. Hankinson, RN, ScD; Meir J. Stampfer, MD, DrPH

Arch Intern Med. 2004;164:1519-1524.

Background  Analgesics are commonly used and may impair kidney function. However, limited prospective information is available on the long-term effects of aspirin, other nonsteroidal anti-inflammatory drugs (NSAIDs), and acetaminophen on renal function.

Methods  A total of 1697 women participating in the Nurses' Health Study provided information on a mailed questionnaire in 1999 about lifetime use of acetaminophen, aspirin, and NSAIDs and provided blood samples in 1989 and 2000. The main outcome was change in estimated glomerular filtration rate (GFR) in 11 years. Multivariate logistic regression was used to determine the odds of developing the outcome according to lifetime analgesic intake.

Results  The mean ± SD estimated GFR decreased from 88 ± 17 to 79 ± 17 mL/min per 1.73 m². There were no substantial differences in the unadjusted or estimated GFR levels among the categories of lifetime intake for the 3 analgesic groups at baseline or after 11 years. Acetaminophen use was associated with an increased risk of a GFR decline of at least 30 mL/min per 1.73 m² (P trend = .01) and a GFR decline of 30% or greater (P trend<.001), but aspirin and NSAID use were not. Compared with women consuming less than 100 g of acetaminophen, multivariate-adjusted odds ratio (95% confidence intervals) for a decline in GFR of at least 30 mL/min per 1.73 m² for women consuming more than 3000 g was 2.04 (1.28-3.24).

Conclusions  Higher lifetime use of aspirin and NSAIDs is not associated with renal function decline, but high acetaminophen use may increase the risk of loss of renal function. The absolute risk of renal function decline due to even high lifetime analgesic intake seems to be modest.

From the Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School (Drs Curhan, Knight, Rosner, Hankinson, and Stampfer), and the Departments of Epidemiology (Drs Curhan, Hankinson, and Stampfer) and Nutrition (Dr Stampfer), Harvard School of Public Health, Boston, Mass. The authors have no relevant financial interest in this article.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Over-the-Counter Analgesic Use
De Broe and Elseviers
J. Am. Soc. Nephrol. 2009;20:2098-2103.
ABSTRACT | FULL TEXT  

Post-menopausal hormone use and albuminuria
Schopick et al.
Nephrol Dial Transplant 2009;0:gfp321v1-gfp321.
ABSTRACT | FULL TEXT  

Acetaminophen, aspirin and progression of advanced chronic kidney disease
Evans et al.
Nephrol Dial Transplant 2009;24:1908-1918.
ABSTRACT | FULL TEXT  

Use of Nonsteroidal Antiinflammatory Agents and Incidence of Ovarian Cancer in 2 Large Prospective Cohorts
Pinheiro et al.
Am J Epidemiol 2009;169:1378-1387.
ABSTRACT | FULL TEXT  

Pain management in patients with chronic kidney disease
Pham et al.
NDT Plus 2009;2:111-118.
ABSTRACT | FULL TEXT  

Kidney function decline and physical function in women
Lin and Curhan
Nephrol Dial Transplant 2008;23:2827-2833.
ABSTRACT | FULL TEXT  

Long-term Aspirin Use and Mortality in Women
Chan et al.
Arch Intern Med 2007;167:562-572.
ABSTRACT | FULL TEXT  

Efficacy and Safety of Angiotensin II Receptor Blockade in Elderly Patients With Diabetes
Winkelmayer et al.
Diabetes Care 2006;29:2210-2217.
ABSTRACT | FULL TEXT  

Use of Analgesics and Nonsteroidal Anti-inflammatory Drugs, Genetic Predisposition, and Bladder Cancer Risk in Spain.
Fortuny et al.
Cancer Epidemiol. Biomarkers Prev. 2006;15:1696-1702.
ABSTRACT | FULL TEXT  

Nonsteroidal Antiinflammatory Drugs, Acetaminophen, and the Risk of Cardiovascular Events
Chan et al.
Circulation 2006;113:1578-1587.
ABSTRACT | FULL TEXT  

Non-Narcotic Analgesic Dose and Risk of Incident Hypertension in US Women
Forman et al.
Hypertension 2005;46:500-507.
ABSTRACT | FULL TEXT  

Long-term Use of Aspirin and Nonsteroidal Anti-inflammatory Drugs and Risk of Colorectal Cancer
Chan et al.
JAMA 2005;294:914-923.
ABSTRACT | FULL TEXT  

Acetaminophen Use Associated with Decreased Renal Function
JWatch Gastroenterology 2004;2004:7-7.
FULL TEXT  

Acetaminophen Use Associated with Decreased Renal Function
JWatch General 2004;2004:1-1.
FULL TEXT