ArticleJournal of general internal medicine2020
Use of Potentially Nephrotoxic Medications by U.S. Adults with Chronic Kidney Disease: NHANES, 2011-2016.
Article in Journal of general internal medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 39 citations in OpenAlex.
- Article
- HIV, Nephrotoxic Medications, and Chronic Kidney Disease: Prevalence, Risk Factors, and Mediation Analyses Among People With and Without HIV Enrolled in the Multicenter AIDS Cohort Study (MACS) / Women's Interagency HIV Study (WIHS) Combined Cohort Study.medRxiv : the preprint server for health sciences · 2025Article
- Article
- Best-Practice Perspectives on Improving Early Detection and Management of Chronic Kidney Disease Associated With Type 2 Diabetes in Primary Care.Clinical diabetes : a publication of the American Diabetes Association · 2024Article
- Article
- Use of nephrotoxic medications in adults with chronic kidney disease in Swedish and US routine care.Clinical kidney journal · 2022Article
- Capsule Commentary on Kurani et al., Use of Potentially Nephrotoxic Medications by U.S. Adults with Chronic Kidney Disease: NHANES, 2011-2016.Journal of general internal medicine · 2020Article
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Authors and funding
9 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundPeople with chronic kidney disease (CKD) are at risk for adverse events and/or CKD progression with use of renally eliminated or nephrotoxic medications.
objectiveTo examine the prevalence of potentially inappropriate medication (PIM) use by U.S. adults by CKD stage and self-reported CKD awareness.
designCross-sectional analysis of National Health and Nutrition Examination Surveys, 2011-2016
participantsNon-pregnant adults with stages 3a (eGFR 45-59 mL/min/1.73 m MAIN MEASURES: PIMs were identified on the basis of KDIGO guidelines, label information, and literature review. We calculated proportions using any and individual PIMs, assessing for differences over CKD awareness within each CKD stage. Analyses were adjusted for age, sex, race/ethnicity, education, comorbidities, and insurance type. KEY
resultsAdjusted proportions of U.S. adults taking any PIM(s) exceeded 50% for all CKD stages and awareness categories, and were highest among CKD-unaware patients with stages 4-5 CKD: 66.6% (95% CI, 55.5-77.8). Proton pump inhibitors, opioids, metformin, sulfonylureas, and non-steroidal anti-inflammatory drugs (NSAIDs) were all used frequently across CKD stages. NSAIDs were used less frequently when CKD-aware by patients with stage 3a CKD (2.2% [95% CI, - 0.3 to 4.7] vs. 10.7% [95% CI, 7.6 to 13.8]) and stages 4-5 CKD (0.8% [95% CI, - 0.9 to 2.5] vs. 16.5% [95% CI, 4.0 to 29.0]). Metformin was used less frequently when CKD-aware by patients with stage 3b CKD (8.1% [95% CI, 0.3-15.9] vs. 26.5% [95% CI, 17.4-35.7]) and stages 4-5 CKD (none vs. 20.8% [95% CI, 1.8-39.8]). The impact of CKD awareness was statistically significant after correction for multiple comparisons only for NSAIDs in stage 3a CKD.
conclusionsPIMs are frequently used by people with CKD, with some impact of CKD awareness on NSAID and metformin use. This may lead to adverse outcomes or hasten CKD progression, reinforcing the need for improved medication management among people with CKD.
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