Background
Methods
Data sources and search strategy
Study selection
Data extraction and quality/validity assessment
Statistical analyses
Results
Study flow and characteristics
First Author, Year | Design; Data; Country | Inclusion Criteria | Exclusion Criteria | Participants | Mean Age (yr) | % Male | Definition of NSAID use (exposure)b
| Definition of AKI (outcome) | Adjusted OR (95%CI) for general population, plus crude OR for CKD pop if available |
---|---|---|---|---|---|---|---|---|---|
Bouvy 2003 [8] | N-CC; PHARMO record linkage system; The Netherlands | >40 years, with ≥2 consecutive prescription for an ACEI | Hospitalisation with renal problems before start an ACEI | 144 cases and 1189 controls | Not reported (all >40 years) | 63.9 cases; 45.4 controls | New/ start of ≥1 prescription in 3 months before hospital admission | Hospitalisation ICD9 584 or 586 | 2.20 (1.10,4.50) |
Huerta 2005 [34] | N-CC; GPRD; UK | 50–84 years, ≥2 years enrolment with GP and ≥1 year since first computerized prescription | Cancer, renal disorder, cirrhosis, systemic connective tissue disease | 386,916 individuals | Not reported (all >50 years) | Not reported | Supply for the most recent prescription lasted until 0–30 days before index date | Clinical diagnosis by a specialist, and SCr >1.7 mg/dl (150 μmol/L) or urea level >47.6 mg/dL (17.0 mmol/L) | 3.23 (1.79,5.82) |
Leonard 2012 [6] | CC; GPRD; UK | Not reported | History of kidney transplant, having outcome of interest during baseline period | 27,982 cases and 1,323,850 controls | 68.6 cases; 66.9 controlsc
| 49.7 cases; 50.4 controls | Active orally administered tNSAID therapy | Diagnostic codes described in succeeding texts supplemented by GP’s free-text | 1.31 (1.25,1.37) |
Murray 1990 [9] | CC; Regenstrief Health Center; US | >18 years, received ibuprofen or acetaminophen during 11May1975- 29Sept1986, baseline and post-prescription SCr and BUN results available | Prescriptions of other NSAIDs, SCr < 0.3 mg/dL (30 μmol/L), BUN < 5 mg/dL (1.8 μmol/L) | 4790 cases and 8205 controls | Not reported | 27.4 cases N/A controls | Patients received first prescription of ibuprofen between 11May1975- 29Sept1986 | Patients with normal baseline values, SCr >1.2 mg/dL (110 μmol/L) or BUN > 18 mg/dL (6.4 μmol/L); Patients with elevated baseline values, SCr or BUN ≥10%increase | 1.05 (0.88,1.26) |
Perez Gutthann 1996 [36] | CC; Saskatchewan health plan information; Canada | ≥1 NSAID prescription during study period | Malignant neoplasm, CRF, in-hospital disease onset, insufficient data, other systemic/ renal conditions | 228,392 members | Not reported | 45.5 | Most recent prescription filled 0–30 days before index | ICD9 580.9, 581, 583.2, 583.6–583.9, 584, 586, 593.9 | 4.10 (1.50,10.8) |
First Author, Year | Design; Data; Country | Inclusion Criteria | Exclusion Criteria | Study Sample | Mean Age (yr) | % Male | Definition of NSAID use (exposure)b
| Definition of AKI (outcome) | Adjusted OR (95%CI) for general population, plus crude OR for CKD pop if available |
Evans 1995 [31] | CC;MEMO; UK | Resident in Tayside, Scotland registered with a Tayside GP in May 1990 | Not reported | 320 patients and 1238 community controlsd
| Not reported | Not reported | ≥1 oral NSAID prescriptions dispensed during 90 day period prior to the index date | ICD9 583.8, 584.5, 584.7–584.9 | 2.20 (1.49,3.25); Crude OR for CKD population 3.04 (1.68,5.49) |
Griffin 2000 [32] | N-CC; Tennessee Medicaid enrolment files; US | ≥65 years, enrolled in Medicaid ≥ 1 year | End-stage renal disease, hospital-acquired acute renal failure, incomplete demographic data, remote counties residents | 7145 patients and 10,000 controls | Not reported (all ≥65 years) | 31 cases; 23 controls | Nonaspirin, supply of NSAIDs included index date | An admission SCr ≥180 μmol/L (2 mg/dl) and ≥20% increase from baseline or ≥20% decline during hospitalization | 1.58 (1.34,1.86); Crude OR for CKD population 1.80 (1.30, 2.50) |
Schneider 2006 [37] | N-CC; Quebec universal health care program database; Canada | >65 years, filled ≥1 NSAID prescription during 01Jan1999-30June2002, NSAID prescription free ≥1 year before cohort entry | Only use aspirin, renal replacement therapy, renal transplantation, 2 NSAIDs at cohort entry | 121,722 new NSAID users | 78.1 cases; 78.0 controls | 46.1 cases; 32.3 controls | Dispensed NSAID 1–30 days preceding the index date with no previous prescription | ICD9 584, 586 | 2.05 (1.61,2.60); Crude OR for CKD population 1.13 (0.79, 1.62) |
Lafrance 2009 [35] | N-CC; Department of Veterans Affairs (VA) health care system; US | ≥1 NSAID prescription during 01Oct2000-30Sept2006, NSAID prescription free 2 years before cohort entry | History of renal transplantation, maintenance dialysis, or AKI before cohort entry | 1,432,781 new NSAID users | 63 (half >65 years) | 97 | Single NSAID dispensed day + 30 days tolerance period with no previous prescription | Hospitalisation with AKI, AKIN definition | 1.82 (1.68,1.98); Crude OR for CKD population 1.36 (1.30, 1.42) |
Henry 1997 [33] | Matched CC; John Hunter Hospital and Newcastle Master Hospital; Australia | Admitted to study hospitals identified by hospital database | Unfit for interview | 164 cases and 189 controls | 76.6 cases; 75.1 controls | 55.5 cases; 55.0 controls | Any NSAID use in past month (excluding prophylactic aspirin) | Admitted to hospitals with SCr ≥0.15 mmol/L | 1.80 (0.97,3.40); Crude OR for CKD population 5.25 (1.06,26.07) |
First Author, Year | Confounders adjusted in general population |
---|---|
Bouvy 2003 [8] | Age and gender, prior hospital admissions for congestive heart failure, diabetes and for concomitant use of diuretics, low-dose aspirin, antibiotics, paracetamol (acetaminophen), epoetin, corticosteroids, opioids, digoxin, antigout drugs and duration of use of ACE inhibitor |
Huerta 2005 [34] | Sex, age, calendar year, body mass index, HF, hypertension, diabetes, antihypertensive use, oral steroid use, NSAID use, and consultant visits and hospitalizations in the previous year |
Leonard 2012 [6] | Hospitalized in prior 30 days, ever past anemia, ever past coronary disease, ever past heart failure/cardiomyopathy, ever past disorders of stomach function, ever past arthropathies and related disorders, ever past pain, ever past gastrointestinal drug use, ever past cardiovascular system drug use, ever past central nervous system drug use, ever past infection-treating drug use, ever past endocrine system drug use, ever past nutrition and blood drug use, ever past musculoskeletal and joint disease drug use, frusemide use in the prior 28 days, and kidney sensitizer drug exposure in the prior 180 days |
Murray 1990 [9] | Age, gender, race, coronary artery disease, baseline systolic blood pressure, diuretic use, |
Perez Gutthann 1996 [36] | Age, sex, calendar year, cardiovascular risk indicator, recent hospitalization for disorders renal, exposure to NSAIDs, prescription ASA, nephrotoxic drugs |
Evans 1995 [31] | Age, gender, could not find information in other covariates |
Griffin 2000 [32] | Age (65–74, 75–84, > = 85), gender, ethnicity, nursing home resident, recent hospitalization (within 30 days, 31–365 days, none in the past year), concomitant use of loop diuretic, thiazide, ACE inhibitor, and antibiotics (within 30 days), prescription for allopurinol, cyclosporin, gold, sulfinpyrazone, or penidllamine, first prescription for cimetidine in the past 60 days, or procedure code Indicating intravenous radio contrast within the past 30 days |
Schneider 2006 [37] | Age, gender, comorbidity (Hypertension, Diabetes, Heart failure, Cardiovascular disease, Atherosclerosis, Hyperlipidemia, Respiratory disease, Gastrointestinal ulcer disease, Chronic renal failure, Acute renal failure, Renal disease, Renovascular disease, Renal infection, Conditions secondary to renal impairment, Renal manifestation of systemic diseases, Systemic disease and malignancy relevant to renal function), drug use (Oral anticoagulants, Oral corticosteroids, Psychotropic drugs, Thyroid drugs. Current use of aspirin, Use of nephrotoxic drugs, Exposure to contrast media), comorbidity measures (No. of different drugs, Chronic disease score, Charlson index, Health care utilization (>12 physician visits, > = 1 nephrologist visits >1 hospitalization)) |
Lafrance 2009 [35] | Age, gender, race, concurrent disease (Arrhythmia, Chronic kidney disease, Cardiovascular disease, Cancer, Chronic liver disease, Chronic pulmonary disease, Congestive heart failure, Diabetes, Hyperlipidemia, Hypertension, Osteoarthritis, Rheumatoid arthritis, Peptic ulcer/ GERD, PVD, Valvular disease), hospitalization (last 30 days, previous year), drug use (ACEi or ARBs, Beta-blockers, Diuretics, Oral anticoagulants, Platelet aggregation drugs, Nephrotoxic drugs, Corticosteroids, Radio contrast exposure), laboratory (Serum albumin) |
Henry 1997 [33] | Age, history of gout, heart disease and renal disease |