Non-steroidal anti-inflammatory drugs in chronic kidney disease: a systematic review of prescription practices and use in primary care
| Autor: | Claire Lefebvre, Jade Hindié, Michael Zappitelli, Robert W. Platt, Kristian B. Filion |
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| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Population MEDLINE 030204 cardiovascular system & hematology primary care 03 medical and health sciences 0302 clinical medicine systematic review Health care CKD medicine non-steroidal anti-inflammatory drugs 030212 general & internal medicine Medical prescription education Intensive care medicine Transplantation education.field_of_study business.industry nephrotoxicity medicine.disease Checklist 3. Good health Nephrology Cohort Observational study business chronic kidney disease Kidney disease |
| Zdroj: | Clinical Kidney Journal |
| ISSN: | 2048-8513 2048-8505 |
| Popis: | Background Chronic kidney disease (CKD) management focuses on limiting further renal injury, including avoiding nephrotoxic medications such as non-steroidal anti-inflammatory drugs (NSAIDs). We performed a systematic review to evaluate the prevalence of primary care NSAID prescribing in this population. Methods We systematically searched MEDLINE and Embase from inception to October 2017 for observational studies examining NSAID prescribing practices or use in CKD patients in a primary care setting. The methodological quality of included studies was assessed independently by two authors using a modified version of the Agency for Healthcare Research and Quality’s Methodological Evaluation of Observational Research checklist. Results Our search generated 8055 potentially relevant publications, 304 of which were retrieved for full-text review. A total of 14 studies from 13 publications met our inclusion criteria. There were eight cohort and three cross-sectional studies, two quality improvement intervention studies and one prospective survey, representing a total of 49 209 CKD patients. Cross-sectional point prevalence of NSAID use in CKD patients ranged from 8 to 21%. Annual period prevalence rates ranged from 3 to 33%. Meta-analysis was not performed due to important clinical heterogeneity across study populations. Conclusions Evidence suggests that NSAID prescriptions/use in primary care among patients with CKD is variable and relatively high. Future research should explore reasons for this to better focus knowledge translation interventions aimed at reducing NSAID use in this patient population. |
| Databáze: | OpenAIRE |
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