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KMID : 1011320100030020074
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Journal of Pharmacoepidemiology and Risk Management
2010 Volume.3 No. 2 p.74 ~ p.80
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Use of Nonsteroidal Anti-inflammatory Drugs (NSAIDs) and Risk of Acute Renal Failure among the Elderly Diabetic Patients: A Case-crossover Study
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Song Jong-Im
Choi Nam-Kyong
Jung Sun-Young
Lee Joong-Yub
Seong Jong-Mi
Kim Ye-Jee
Park Byung-Joo
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Abstract
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Objective: To evaluate the risk of acute renal failure (ARF) associated with nonsteroidal anti-inflammatory drugs (NSAIDs) or celecoxib among the elderly diabetic patients in Korea using a case-crossover design.
Methods: We used Health Insurance Review & Assessment Service (HIRA) claims database from 1 January 2005 to 30 June 2006. Study cases were ARF patients among the elderly diabetic patients during the study period. We analyzed the risk of ARF associated with NSAIDs or celecoxib by 1:2 matched case-crossover design. Hazard period was defined by 30-day window before the index date. A 30-day washout period was chosen between the end of hazard period and the start of control period. Two consecutive control periods were defined as 30-day window. The odd ratios (ORs) and their 95% confidence intervals (CIs) were calculated by conditional logistic regression.
Results: Within the HIRA database of 4,130,252 elderly patients, a total of 675,687 diabetic patients were identified. Among the diabetic patients 8,650 ARF cases were found. The ORs of ARF in NSAIDs users except celecoxib, celecoxib users, and celecoxib and other NSAIDs users compared with NSAIDs non-users were 1.8 (95% CI: 1.70-1.96), 2.7 (95% CI: 1.95-3.76), and 3.1 (95% CI: 2.09-4.46), respectively.
Conclusion: NSAIDs as well as celecoxib increased the risk of ARF in the elderly diabetic patients. Therefore these drugs should be used with caution for the patients vulnerable to renal damage like the elderly diabetic patients.
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KEYWORD
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Nonsteroidal anti-inflammatory drugs (NSAIDs), Celecoxib, Acute renal failure, Elderly, Diabetes, Case-crossover design
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