@article {LinBJGPO.2021.0208, author = {Sharon X Lin and Thomas Phillips and David Culliford and Christopher Edwards and Christopher Holroyd and Kinda Ibrahim and Ravina Barrett and Clare Howard and Ruth Johnson and Jo Adams and Mathew Stammers and Adam Rischin and Paul Rutter and Nicola Barnes and Paul J Roderick and Simon DS Fraser}, title = {Characterising risk of non-steroidal anti-inflammatory drug-related acute kidney injury: a retrospective cohort study}, elocation-id = {BJGPO.2021.0208}, year = {2022}, doi = {10.3399/BJGPO.2021.0208}, publisher = {Royal College of General Practitioners}, abstract = {Background Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly prescribed for pain and inflammation. NSAID complications include acute kidney injury (AKI), causing burden to patients and health services through increased morbidity, mortality, and hospital admissions.Aim To measure the extent of NSAID prescribing in an adult population, the degree to which patients with potential higher risk of AKI were exposed to NSAIDs, and to quantify their risk of AKI.Design \& setting Retrospective 2-year closed-cohort study.Method A retrospective cohort of adults was identified from a pseudonymised electronic primary care database in Hampshire, UK. The cohort had clinical information, prescribing data, and complete GP- and hospital-ordered biochemistry data. NSAID exposure (minimum one prescription in a 2-month period) was categorised as never, intermittent, and continuous, and first AKI using the national AKI e-alert algorithm. Descriptive statistics and logistic regression were used to explore NSAID prescribing patterns and AKI risk.Results The baseline population was 702 265. NSAID prescription fell from 19 364 (2.8\%) to 16 251 (2.4\%) over 2 years. NSAID prescribing was positively associated with older age, female sex, greater socioeconomic deprivation, and certain comorbidities (diabetes, hypertension, osteoarthritis, and rheumatoid arthritis) and negatively with cardiovascular disease (CVD) and heart failure. Among those prescribed NSAIDs, AKI was associated with older age, greater deprivation, chronic kidney disease (CKD), CVD, heart failure, diabetes, and hypertension.Conclusion Despite generally good prescribing practice, NSAID prescribing was identified in some people at higher risk of AKI (for example, patients with CKD and older) for whom medication review and NSAID deprescribing should be considered.}, URL = {https://bjgpopen.org/content/early/2022/01/10/BJGPO.2021.0208}, eprint = {https://bjgpopen.org/content/early/2022/01/10/BJGPO.2021.0208.full.pdf}, journal = {BJGP Open} }