AbstractIntroduction Limited studies have evaluated risk of stroke associated with the use of nonsteroidal anti-inflammatory drugs (NSAIDs) in patients with end-stage kidney disease. We examined the adverse effects of selective and nonselective NSAIDs use on the risk of stroke in dialysis patients. Methods A case-crossover study was conducted using medical claims data from the National Health Insurance Research Database in Taiwan. We identified patients with ischemic and hemorrhagic stroke (defined as ICD-9-CM-codes: 433, 434, and 436 for ischemic stroke; and 430 and 431 for hemorrhagic stroke) from inpatient claims during the period from 2003 to 2012. Conditional logistic regression models with adjustment for potential confounders were used to determine the effects of NSAID use on stroke. Results A total of 1,190 dialysis patients with stroke were identified from 2003 to 2012. The results indicate a 1.31-fold increased risk of stroke related to NSAID use during the 30 days prior to a stroke (adjusted odds ratio (AOR)=1.31; 95% confidence interval (CI): 1.03-1.66); likewise, an excessive risk of ischemic stroke was observed (AOR=1.34; 95% CI: 1.02-1.77). When classifying NSAIDs into selective and nonselective groups, nonselective NSAID use was significantly associated with an increased risk of stroke (AOR=1.27; 95% CI: 1.00-1.61). Conclusion In summary, the results show supportive evidence that NSAID use increased the risk of stroke in dialysis patients, which suggests the importance of closely monitoring the transient effects of initial NSAID treatment to patients on dialysis.
Date:
2017-05
Relation:
Kidney International Reports. 2017 May;2(3):400-409.
