Tuesday, July 14, 2009

What Are the Safe Pain Medications for Patients with CKD?

Pain medications have been a hot topic lately for obvious reasons. So, what analgesics are safe to use in patients with chronic kidney disease?

According to a population-based Swedish cohort study published in Nephrology Dialysis Transplantation last month, aspirin and acetaminophen are two choices that can be used safely even into advance stages of CKD.

Marie Evans, MD, of the Karolinska Institute and University Hospital, Stockholm, Sweden, and her colleagues analyzed the decline in estimated glomerular filtration rate (eGFR) over five to seven years among 801 patients with advanced CKD.

Regular acetaminophen users progressed 0.93 mL/min/1.73 m2 per year slower than non-regular users. Regular aspirin users progressed 0.80 mL/min/1.73 m2 per year slower than non-regular users. “Different levels of lifetime cumulative dose of acetaminophen and aspirin did not significantly affect the progression rate,” the authors observed.

The conclusion of the study suggests that single substance use of aspirin or acetaminophen can safely be used in advanced CKD (Stage 4-5) without any increased risk of accelerated renal decline.

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