Analgesic use and renal function in men

Context Several case-control studies suggest an association between analges ic use and increased risk of chronic renal disease, but few cohort studies have examined this association. Objective To determine whether analgesic use is associated with risk of ren al dysfunction. Design and Setting Cohort study of analgesic use data from the Physicians' Health Study, which lasted 14 years from September 1982 to December 1995 wi th annual follow-up. Participants A total of 11 032 initially healthy men who provided blood sam ples and self-report of analgesic use. Main Outcome Measures Elevated creatinine level defined as 1.5 mg/dL (133 m u mol/L) or higher and a reduced creatinine clearance defined as 55 mL/min (0.9 mL/s) or less, and self-reported use of acetaminophen, aspirin, and ot her nonsteroidal antiinflammatory drugs (never [<12 pills]; 12-1499 pills; 1500-2499 pills; and <greater than or equal to>2500 pills). Results PI total of 460 men had elevated creatinine levels (4.2%) and 1258 had reduced creatinine clearance (11.4%). Mean creatinine levels and creati nine clearances were similar among men who did not use analgesics and those who did, even at total intakes of 2500 or more pills. In multivariable ana lyses adjusted for age; body mass index; history of hypertension, elevated cholesterol, and diabetes; occurrence of cardiovascular disease; physical a ctivity; and use of other analgesics, the relative risks of elevated creati nine level associated with intake of 2500 or more pills were 0.83 (95% conf idence interval [CI], 0.50-1.39, P for trend =.05) for acetaminophen, 0.98 (95% CI, 0.53-1.81; P for trend =.96) for aspirin, and 1.07 (95% CI, 0.71-1 .64; P for trend =.86) for other nonsteroidal anti-inflammatory drugs. Ho a ssociation was observed be tween analgesic use and reduced creatinine clear ance. Conclusions Moderate analgesic use in this cohort study of initially health y men was not associated with increased risk of renal dysfunction.