Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Aug 6.
doi: 10.1007/s40266-025-01239-9. Online ahead of print.

Effects of NSAIDs on Early CKD Development: A 10-Year Population-Based Study Using the Korean Senior Cohort

Jung-Sun Lim  1 , Sujeong Han  2 , Jong Seung Kim  2 , Sunyoung Kim  3 , Bumjo Oh  4   5
Affiliations

Effects of NSAIDs on Early CKD Development: A 10-Year Population-Based Study Using the Korean Senior Cohort

Jung-Sun Lim et al. Drugs Aging. .

Abstract

Background: Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used for pain management but are associated with nephrotoxicity, particularly in senior populations. While the acute nephrotoxicity of NSAIDs is well established, evidence on their long-term effects on renal function-particularly in community-dwelling older adults-has been mixed across studies.

Objectives: This study investigated the association between NSAID use and chronic kidney disease (CKD) risk in the general senior population.

Methods: Data from the National Health Insurance Service-Senior Cohort (NHIS-SC) in South Korea were analyzed, including 1812 participants (604 NSAID users and 1208 controls) matched 1:2 by propensity score. Kidney dysfunction was defined as glomerular filtration rate (eGFR) < 60 mL/min/1.73m2 with a ≥ 10% decline from baseline. Hazard ratios (HRs) for CKD were estimated using Cox regression.

Results: NSAID use was associated with an increased CKD risk (HR 1.46; 95% confidence interval (CI) 1.11-1.93) and faster eGFR decline. Subgroup analysis showed elevated risks for Cox-1 (HR 1.53) and Cox-2 inhibitors (HR 1.61). End-stage renal disease (ESRD) incidence was rare and not significant.

Conclusions: NSAIDs increase CKD risk and accelerate kidney function decline in senior individuals. Cautious prescription and regular kidney monitoring are recommended, and further randomized trials are needed.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethics approval: This study was approved by the Institutional Review Board of Seoul National University (IRB no. 07-2023-43). Data were provided by the National Health Insurance Service (NHIS-2024-2-060). All procedures were conducted in accordance with the ethical standards of the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. Consent for publication: Not applicable. This study used de-identified, publicly available data from the NHIS-Senior Cohort. Authors’ contributions: Jung-sun Lim designed the statistical analysis and drafted the manuscript. Bumjo Oh conceptualized the study, supervised the research process, and provided critical revision and oversight. Sunyoung Kim contributed significantly to manuscript revision, interpretation of results, and reviewer responses. Sujeong Han and Jong Seung Kim reviewed interim drafts and provided clinical feedback throughout the study. All authors read and approved the final version of the manuscript. Conflicts of interest: All authors (Jung-sun Lim, Sujeong Han, Jong Seung Kim, Sunyoung Kim, and Bumjo Oh) declare that they have no competing interests. Funding: Open Access funding enabled and organized by Seoul National University. This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. Data availability: The data that support the findings of this study are available from the National Health Insurance Service (NHIS) of Korea. These data can be accessed by researchers upon request and approval from the NHIS. Access requires submission of a research proposal and payment of associated data usage fees. Code availability: Not applicable.

References

    1. Smalley WE, Ray WA, Daugherty JR, Griffin MR. Nonsteroidal anti-inflammatory drugs and the incidence of hospitalizations for peptic ulcer disease in elderly persons. Am J Epidemiol. 1995;141(6):539–45. - PubMed
    1. Bindu S, Mazumder S, Bandyopadhyay U. Non-steroidal anti-inflammatory drugs (NSAIDs) and organ damage: a current perspective. Biochem Pharmacol. 2020;180: 114147. - PubMed - PMC
    1. Weir MR. Renal effects of nonselective NSAIDs and coxibs. Cleve Clin J Med. 2002;69(Suppl 1):Si53–8. - PubMed
    1. Zhang X, Donnan PT, Bell S, Guthrie B. Non-steroidal anti-inflammatory drug induced acute kidney injury in the community dwelling general population and people with chronic kidney disease: systematic review and meta-analysis. BMC Nephrol. 2017;18(1):256. - PubMed - PMC
    1. Hörl WH. Nonsteroidal anti-inflammatory drugs and the kidney. Pharmaceuticals (Basel). 2010;3(7):2291–321. - PubMed

LinkOut - more resources