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Analgesic Use and Renal Function in Men
Kathryn M. Rexrode, MD;
Julie E. Buring, ScD;
Robert J. Glynn, ScD;
Meir J. Stampfer, MD;
Linda D. Youngman, PhD;
J. Michael Gaziano, MD,MPH
JAMA. 2001;286:315-321.
Context Several case-control studies suggest an association between analgesic use and increased risk of chronic renal disease, but few cohort studies have examined this association.
Objective To determine whether analgesic use is associated with risk of renal dysfunction.
Design and Setting Cohort study of analgesic use data from the Physicians' Health Study, which lasted 14 years from September 1982 to December 1995 with annual follow-up.
Participants A total of 11 032 initially healthy men who provided blood samples and self-report of analgesic use.
Main Outcome Measures Elevated creatinine level defined as 1.5 mg/dL (133 µmol/L) or higher and a reduced creatinine clearance defined as 55 mL/min (0.9 mL/s) or less, and self-reported use of acetaminophen, aspirin, and other nonsteroidal anti-inflammatory drugs (never [<12 pills]; 12-1499 pills; 1500-2499 pills; and  2500 pills).
Results A total of 460 men had elevated creatinine levels (4.2%) and 1258 had reduced creatinine clearance (11.4%). Mean creatinine levels and creatinine clearances were similar among men who did not use analgesics and those who did, even at total intakes of 2500 or more pills. In multivariable analyses adjusted for age; body mass index; history of hypertension, elevated cholesterol, and diabetes; occurrence of cardiovascular disease; physical activity; and use of other analgesics, the relative risks of elevated creatinine level associated with intake of 2500 or more pills were 0.83 (95% confidence interval [CI], 0.50-1.39; P for trend = .05) for acetaminophen, 0.98 (95% CI, 0.53-1.81; P for trend = .96) for aspirin, and 1.07 (95% CI, 0.71-1.64; P for trend = .86) for other nonsteroidal anti-inflammatory drugs. No association was observed between analgesic use and reduced creatinine clearance.
Conclusions Moderate analgesic use in this cohort study of initially healthy men was not associated with increased risk of renal dysfunction.
Author Affiliations: Division of Preventive Medicine, Channing Laboratory, Department of Medicine, Brigham and Women's Hospital (Drs Rexrode, Stampfer, Gaziano, and Glynn), Department of Ambulatory Care and Prevention, Harvard Medical School (Dr Buring), Department of Epidemiology, Harvard School of Public Health (Drs Stampfer and Buring), and Department of Biostatistics, Harvard School of Public Health (Dr Glynn), Boston, Mass; Office of Research, US Food and Drug Administration, Laurel, Md (Dr Youngman); and Massachusetts Veterans Epidemiology Research and Information Center and VA Boston Healthcare System, Boston, Mass (Dr Gaziano).
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