Renal safety of Long-Term Non-steroidal Anti-inflammatory drugs use in patients with ankylosing spondylitis
Abstract Objectives We investigate the renal safety of long-term non-steroidal anti-inflammatory drugs (NSAIDs) exposure in patients with ankylosing spondylitis (AS). Methods We analyzed electronic medical records from Asan Medical Center (AMC) and Seoul National University Bundang Hospital (SNUBH),...
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Nature Portfolio
2025-07-01
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| Online Access: | https://doi.org/10.1038/s41598-025-07146-8 |
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| author | Young-Eun Kim Seo Young Park Ji Sung Lee You-Jung Ha Sooyoung Yoo Seok Kim Soo Min Ahn Seokchan Hong Chang‑Keun Lee Bin Yoo Ji Seon Oh Yong‑Gil Kim |
| author_facet | Young-Eun Kim Seo Young Park Ji Sung Lee You-Jung Ha Sooyoung Yoo Seok Kim Soo Min Ahn Seokchan Hong Chang‑Keun Lee Bin Yoo Ji Seon Oh Yong‑Gil Kim |
| author_sort | Young-Eun Kim |
| collection | DOAJ |
| description | Abstract Objectives We investigate the renal safety of long-term non-steroidal anti-inflammatory drugs (NSAIDs) exposure in patients with ankylosing spondylitis (AS). Methods We analyzed electronic medical records from Asan Medical Center (AMC) and Seoul National University Bundang Hospital (SNUBH), including 1,618 and 995 AS patients, respectively, with over one year of follow-up and no pre-existing kidney disease (baseline eGFR ≥ 60). NSAID exposure was quantified using the medication possession rate (MPR), and its impact on estimated glomerular filtration rate (eGFR) changes was assessed using linear mixed-effects models. Two approaches were employed: a 1-year interval analysis assuming a stable effect over time without time interaction, and a 3-year interval analysis incorporating time interaction to evaluate cumulative NSAID effects and changes in the relationship with eGFR decline over time. Results In the analysis without time interaction, NSAID use was associated with a decline in annual eGFR, with patients having 100% NSAID use experiencing a decrease in eGFR (β, -0.7; 95% CI: -1.1 to -0.3) compared to those with no NSAID use. A meta-analysis showed that every 1% increase in NSAID MPR associate with eGFR decline (β, -0.007; 95% CI: -0.011 to -0.004). However, the time-interaction analysis found no significant cumulative eGFR decline across most time points, except at the 9-year follow-up in SNUBH (β, -5.1; 95% CI, -9.2 to -1.1) and 18-year follow-up in AMC (β, -8.9; 95% CI, -15.9 to -1.9). Conclusion This study demonstrates that while NSAID use may affect renal function in the short term, its long-term cumulative effects on renal impairment appear non-significant. |
| format | Article |
| id | doaj-art-236b855b11f24c73b22b5e192e2d831e |
| institution | Kabale University |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj-art-236b855b11f24c73b22b5e192e2d831e2025-08-20T04:01:36ZengNature PortfolioScientific Reports2045-23222025-07-0115111110.1038/s41598-025-07146-8Renal safety of Long-Term Non-steroidal Anti-inflammatory drugs use in patients with ankylosing spondylitisYoung-Eun Kim0Seo Young Park1Ji Sung Lee2You-Jung Ha3Sooyoung Yoo4Seok Kim5Soo Min Ahn6Seokchan Hong7Chang‑Keun Lee8Bin Yoo9Ji Seon Oh10Yong‑Gil Kim11Division of Rheumatology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of MedicineDepartment of Statistics and Data Science, Korea National Open UniversityClinical Research Center, Asan Institute for Life Sciences, Asan Medical CenterDivision of Rheumatology, Department of Internal Medicine, Seoul National University Bundang HospitalHealthcare ICT Research Center, Office of eHealth Research and Businesses, Seoul National University Bundang HospitalHealthcare ICT Research Center, Office of eHealth Research and Businesses, Seoul National University Bundang HospitalDivision of Rheumatology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of MedicineDivision of Rheumatology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of MedicineDivision of Rheumatology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of MedicineDivision of Rheumatology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of MedicineDivision of Rheumatology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of MedicineDivision of Rheumatology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of MedicineAbstract Objectives We investigate the renal safety of long-term non-steroidal anti-inflammatory drugs (NSAIDs) exposure in patients with ankylosing spondylitis (AS). Methods We analyzed electronic medical records from Asan Medical Center (AMC) and Seoul National University Bundang Hospital (SNUBH), including 1,618 and 995 AS patients, respectively, with over one year of follow-up and no pre-existing kidney disease (baseline eGFR ≥ 60). NSAID exposure was quantified using the medication possession rate (MPR), and its impact on estimated glomerular filtration rate (eGFR) changes was assessed using linear mixed-effects models. Two approaches were employed: a 1-year interval analysis assuming a stable effect over time without time interaction, and a 3-year interval analysis incorporating time interaction to evaluate cumulative NSAID effects and changes in the relationship with eGFR decline over time. Results In the analysis without time interaction, NSAID use was associated with a decline in annual eGFR, with patients having 100% NSAID use experiencing a decrease in eGFR (β, -0.7; 95% CI: -1.1 to -0.3) compared to those with no NSAID use. A meta-analysis showed that every 1% increase in NSAID MPR associate with eGFR decline (β, -0.007; 95% CI: -0.011 to -0.004). However, the time-interaction analysis found no significant cumulative eGFR decline across most time points, except at the 9-year follow-up in SNUBH (β, -5.1; 95% CI, -9.2 to -1.1) and 18-year follow-up in AMC (β, -8.9; 95% CI, -15.9 to -1.9). Conclusion This study demonstrates that while NSAID use may affect renal function in the short term, its long-term cumulative effects on renal impairment appear non-significant.https://doi.org/10.1038/s41598-025-07146-8Ankylosing spondylitisNon-steroidal anti-inflammatory drugsKidneySafety |
| spellingShingle | Young-Eun Kim Seo Young Park Ji Sung Lee You-Jung Ha Sooyoung Yoo Seok Kim Soo Min Ahn Seokchan Hong Chang‑Keun Lee Bin Yoo Ji Seon Oh Yong‑Gil Kim Renal safety of Long-Term Non-steroidal Anti-inflammatory drugs use in patients with ankylosing spondylitis Scientific Reports Ankylosing spondylitis Non-steroidal anti-inflammatory drugs Kidney Safety |
| title | Renal safety of Long-Term Non-steroidal Anti-inflammatory drugs use in patients with ankylosing spondylitis |
| title_full | Renal safety of Long-Term Non-steroidal Anti-inflammatory drugs use in patients with ankylosing spondylitis |
| title_fullStr | Renal safety of Long-Term Non-steroidal Anti-inflammatory drugs use in patients with ankylosing spondylitis |
| title_full_unstemmed | Renal safety of Long-Term Non-steroidal Anti-inflammatory drugs use in patients with ankylosing spondylitis |
| title_short | Renal safety of Long-Term Non-steroidal Anti-inflammatory drugs use in patients with ankylosing spondylitis |
| title_sort | renal safety of long term non steroidal anti inflammatory drugs use in patients with ankylosing spondylitis |
| topic | Ankylosing spondylitis Non-steroidal anti-inflammatory drugs Kidney Safety |
| url | https://doi.org/10.1038/s41598-025-07146-8 |
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