Prevalence, Determinants and Clinical Correlates of Albuminuria in Nigerians with Frequent Use of Non-steroidal Anti-inflammatory Drugs

Abstract

BACKGROUND: Non-steroidal anti-inflammatory drugs (NSAIDs) are used for treating fever, inflammatory and painful conditions. Their use is more common in low-income settings where artisans and manual labourers take them for work-related pain. High doses and prolonged use can cause albuminuria. AIM: The study assessed albuminuria, (a surrogate maker for kidney damage) in frequent NSAID use. SUBJECTS AND METHODS: The cross-sectional study involved 100 frequent NSAID users and 100 age- and sex-matched healthy controls. History and examination were conducted. Urine samples were collected for analysis, microscopy and albumin-creatinine ratio and, blood samples were collected for creatinine-based glomerular filtration rate (GFR) and haematocrit. RESULTS: The mean age of NSAID users with albuminuria was 63.1 + 4.2 years, which was significantly higher than without albuminuria (41.8 + 4.5 years), P < 0.001. Albuminuria and GFR decline were more common in NSAID users than controls, P < 0.001 and P < 0.001, respectively. The mean systolic blood pressure of NSAID users was significantly higher than the controls, P < 0.001. Amongst the NSAID users, albuminuria was positively correlated with metabolic acidosis but negatively correlated with haematocrit, P = 0.04 and P = 0.002, respectively. Albuminuria was common in NSAID users who took herbal remedies and ibuprofen. Associates of albuminuria were advancing age (odds ratio [OR]: 2.17 [confidence interval (CI):1.36-4.52], P = 0.002), prolonged use (OR: 1.97 [CI: 0.05-2.09], P = 0.02), combination therapy (OR: 2.84 [CI: 1.03-6.29], P = 0.001) and ibuprofen use (OR: 1.93 [CI: 1.07-2.45], P = 0.02). CONCLUSION: Albuminuria is common in frequent NSAID users, particularly with advancing age, herbal remedies, anaemia, ibuprofen use and prolonged and combination therapy. It is imperative that NSAIDs should be taken in low doses and for short period.