| Abstract: | Introduction and Aims: One of the major goal of chronic kidney disease (CKD) management is to prevent disease progression. Non-steroidal anti-inflammatory drugs (NSAIDs), a commonly prescribed drugs, have adverse renal effects and should be avoided by CKD patients. The aim of this study is to determine the prevalence of NSAID prescription among advanced CKD patients and identify the predictive risk factors.Methods: A nationwide cohort study was conducted. The study used claim data of patients diagnosed with advanced CKD from Taiwan National Health Insurance Research Database.Results: Among 22,515 patients with advanced CKD, 19,544 (87.39%) were prescribed with NSAIDs after advanced CKD was diagnosed. Furthermore, 65.69% of patients with advanced CKD were prescribed with NSAIDs a year before diagnosis, 62.97% were prescribed within a year of advanced CKD diagnosis, and 63.9% were prescribed with NSAIDs a year after starting dialysis. NSAIDs were most frequently prescribed by general practitioners, with 75.55% prescribed before diagnosis, 72.91% after diagnosis, and 69.84% after dialysis. The factors associated with NSAID prescription are age more than 45 years old, hypertension, malignancy, osteoarthritis, rheumatoid arthritis, HIVD, spondylosis enthesopathy, gout, number of clinic visits, and number of times hospitalized.Conclusions: High prevalence of NSAID prescription was observed before advanced CKD diagnosis, recent diagnosis, and post-dialysis in Taiwan. NSAIDs were mostly prescribed by general practitioners. Healthcare providers should pay attention to the elderly and patients with pain-related problems to reduce NSAID prescription to patients with advanced CKD. |
