{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T07:36:56Z","timestamp":1772609816965,"version":"3.50.1"},"reference-count":23,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2014,7,30]]},"published-print":{"date-parts":[[2014,8]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>We aimed to quantify the short-term effect of non-steroidal anti-inflammatory drugs (NSAIDs), aspirin and paracetamol analgesia dose prescribing on estimated glomerular filtration rate (eGFR) decline in the general practice population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>A population-based longitudinal clinical data linkage cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Two large general practices in North Staffordshire, UK.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>Patients aged 40\u2005years and over with \u22652 eGFR measurements spaced \u226590\u2005days apart between 1 January 2009 and 31 December 2010 were selected.<\/jats:p><\/jats:sec><jats:sec><jats:title>Exposure<\/jats:title><jats:p>Using WHO Defined Daily Dose standardised cumulative analgesia prescribing, patients were categorised into non-user, normal and high-dose groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Outcome measure<\/jats:title><jats:p>The primary outcome was defined as a &gt;5\u2005mL\/min\/1.73\u2005m<jats:sup>2<\/jats:sup>\/year eGFR decrease between the first and last eGFR. Logistic regression analyses were used to estimate risk, adjusting for sociodemographics, comorbidity, baseline chronic kidney disease (CKD) status, renin-angiotensin-system inhibitors and other analgesia prescribing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 4145 patients (mean age 66\u2005years, 55% female) with an analgesia prescribing prevalence of 17.2% for NSAIDs, 39% for aspirin and 22% for paracetamol and stage 3\u20135 CKD prevalence was 16.1% (n=667). Normal or high-dose NSAID and paracetamol prescribing was not significantly associated with eGFR decline. High-dose aspirin prescribing was associated with a reduced risk of eGFR decline in patients with a baseline (first) eGFR \u226560\u2005mL\/min\/1.73\u2005m<jats:sup>2<\/jats:sup>; OR=0.52 (95% CI 0.35 to 0.77).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>NSAID, aspirin and paracetamol prescribing over 2\u2005years did not significantly affect eGFR decline with a reduced risk of eGFR decline in high-dose aspirin users with well-preserved renal function. However, the long-term effects of analgesia use on eGFR decline remain to be determined.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bmjopen-2014-005581","type":"journal-article","created":{"date-parts":[[2014,8,20]],"date-time":"2014-08-20T05:51:22Z","timestamp":1408513882000},"page":"e005581","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Analgesia dose prescribing and estimated glomerular filtration rate decline: a general practice database linkage cohort study"],"prefix":"10.1136","volume":"4","author":[{"given":"Paul","family":"Nderitu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucy","family":"Doos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vicky Y","family":"Strauss","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Lambie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon J","family":"Davies","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Umesh T","family":"Kadam","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2014,8,19]]},"reference":[{"key":"2024051512273123000_4.8.e005581.1","doi-asserted-by":"publisher","DOI":"10.1053\/ajkd.2002.32799"},{"key":"2024051512273123000_4.8.e005581.2","unstructured":"The National Collaborating Centre for Chronic Conditions. 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