J Rheum Dis.  2023 Apr;30(2):126-132. 10.4078/jrd.2023.0006.

The relationship between long-term use of nonsteroidal anti-inflammatory drugs and kidney function in patients with ankylosing spondylitis

• Koo BS
• Hwang S
• Park SY
• Shin JH
• Kim TH

• KMID: 2541056
• DOI: http://doi.org/10.4078/jrd.2023.0006

Abstract

Objective
Although nonsteroidal anti-inflammatory drugs (NSAIDs) are the first-line treatment for ankylosing spondylitis (AS), their effect on kidney function remains unclear. This longitudinal study investigated the correlation between long-term NSAID use and kidney function in patients with AS using electronic medical records.
Methods
The electronic medical records of 1,280 patients with AS collected from a single center between January 2001 and December 2018 were reviewed. The Assessment of Spondyloarthritis International Society (ASAS) NSAID Intake Score was used to determine the cumulative dose of all NSAIDs prescribed for a different time intervals. Each ASAS NSAID Intake Score was obtained for intervals of 6 months, 1 year, 2 years, 3 years, 5 years, and 10 years. The correlation between the ASAS NSAID Intake Score and final estimated glomerular filtration rate (eGFR) for each interval was investigated.
Results
The mean ASAS Intake Scores for 6-month, 1-year, 2-year, 3-year, 5-year, and 10-year intervals were 55.30, 49.28, 44.84, 44.14, 44.61, and 41.17, respectively. At each interval, the pearson correlation coefficients were −0.018 (95% CI: −0.031 to −0.006, p=0.004), −0.021 (95% CI: −0.039 to −0.004, p=0.018), −0.045 (95% CI: −0.071 to −0.019, p=0.001), −0.069 (95% CI: −0.102 to −0.037, p<0.001), −0.070 (95% CI: −0.114 to −0.026, p=0.002), −0.019 (95% CI: −0.099 to 0.062, p=0.645), respectively. There was a very weak negative relationship between ASAS Intake Score and eGFR at each interval.
Conclusion
Long-term NSAID use did not correlate with kidney function based on real-world data in patients with AS.

Keyword

Anti-inflammatory agents; non-steroidal; Kidney function tests; Renal insufficiency; chronic; Spondylitis; ankylosing

Figure

• 

  Fig. 1 Scatter plots for NSAID Intake Score and eGFR changes in intervals of (A) 6 months, (B) 1 year, (C) 2 years, (D) 3 years, (E) 5 years, and (F) 10 years in overall patients. eGFR: estimated glomerular filtration rate, NSAID: nonsteroidal anti-inflammatory drug.

• 

  Fig. 2 Trend of change of eGFR in patients who have had eGFR <60 mL/min/1.73 m2 at least once during the follow-up period. The numbers represent the NSAID Intake Score during the follow-up period. eGFR: estimated glomerular filtration rate, NSAID: nonsteroidal anti-inflammatory drug.

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