Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

NSAID Exposure Linked by Incident Kidney Problems

JAMA Netw Open; 2019 Feb 15; Nelson, et al

In a large cohort of active young and middle-aged adults, modest but statistically significant associations were noted between the highest observed doses of nonsteroidal anti-inflammatory drug (NSAID) exposure and incident kidney problems. The retrospective, longitudinal cohort study used deidentified medical and administrative data on 764,228 active-duty US Army soldiers serving between January 1, 2011, and December 31, 2014. Interventions included mean total defined daily doses of prescribed NSAIDs dispensed per month in the prior 6 months. Researchers found:

  • 65.8% of participants (85.8% men, median age 27.0 years) were not dispensed prescription NSAIDs in the prior 6 months; 17.9% were dispensed 1 to 7 mean total defined daily doses per month, and 16.3% received >7 defined daily doses per month.
  • There were 2,356 acute kidney injury outcomes (0.3%) and 1,634 chronic kidney disease outcomes (0.2%) observed.
  • NSAID prescriptions of >7 daily defined doses per month were associated with modest but significant increases in the adjusted hazard ratios of acute and chronic kidney disease diagnoses.


Nelson DA, Marks ES, Deuster PA, O’Connor FG, Kurina LM. Association of nonsteroidal anti-inflammatory drug prescriptions with kidney disease among active young and middle-aged adults. JAMA Netw Open. 2019;2(2):e187896. doi:10.1001/jamanetworkopen.2018.7896.

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