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Background and objectivesNonsteroidal anti-inflammatory drugs (NSAIDs) have been associatedwith AKI. Their
association with nephrotic syndrome has not been systematically studied. This study aimed to assess the risk of
nephrotic syndrome associated with NSAID use.
Design, setting, participants, & measurements A matched case-control study was performed in the UK primary
care database. Cases were patients with a first diagnosis of nephrotic syndrome and controls were those without
nephrotic syndrome. NSAID exposure (grouped either based on cyclooxygenase enzyme selectivity and chemical
groups) was classified as either current (use at the nephrotic syndrome diagnosis date and corresponding date in
the control group), recent, or past use. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated
using unconditional logistic regression analysis.
Results We included 2620 cases and 10,454 controls. Compared with non-use, current use of 15–28 days and .28
days of conventional NSAIDs was associated with a higher relative risk of nephrotic syndrome: adjusted OR, 1.34;
95% CI, 1.06 to 1.70, and OR, 1.42; 95% CI, 0.79 to 2.55, respectively. Also, recent use (discontinuation 1–2 months
before nephrotic syndrome diagnosis date; OR, 1.55; 95% CI, 1.11 to 2.15) and past use (discontinuation 2months-2
years; OR, 1.24; 95% CI, 1.07 to 1.43), but not current use of ,15 days (OR, 0.78; 95% CI, 0.46 to 1.31) nor past use
(discontinuation .2 years; OR, 0.96; 95% CI, 0.85 to 1.09) were associated with a higher relative risk of nephrotic
syndrome as well as past use of selective COX-2 inhibitors (discontinuation 2–24 months; OR, 1.24; 95% CI, 0.98 to
1.58). Categorization based on chemical groups showed that acetic acid and propionic acid derivatives were
associated with a higher risk of nephrotic syndrome.
Conclusions The use of conventional NSAIDs was associated with a higher risk of nephrotic syndrome starting
from at least 2 weeks of exposure, as well as for recent and past exposure up to 2 years before the diagnosis of
nephrotic syndrome. This higher risk appeared mainly attributable to acetic acid and propionic acid derivatives |
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