As we age and try and keep moving we notice the severe aches and pains from wear and tear and osteoarthritis that we feel at the start of a day. To relieve those feelings we often reach for the over the counter bottle of Advil ( ibuprofen) or Aleve ( naproxen sodium) knowing full well that the medication will help the aches and pains but may irritate our stomach or contribute to the downfall of our kidneys.
The problem and decision making in prescribing NSAIDs is even more critical in patients with Rheumatoid Arthritis. A recent scientific publication in the Annals of Rheumatic Disease 2015:74: 718-723 authored by B Moeller MD of the Unselspital-University Hospital, Bern, Switzerland looked at this question. They “found reassuring data regarding preserved renal function despite long-term NSAID use in Rheumatoid Arthritis (RA) patients.” Kidney function was followed on 4101 RA patients between 1996 and 2007. 2739 patients used NSAID while 136 2 patients did not.
They assessed and followed kidney function by the accepted methods of calculating the Glomerular Filtration Rate ( GFR). Their results revealed that there was no decline in kidney function in patients who had less than stage 4 Chronic Kidney Disease at the start of the study. They went on to recommend that if a patient’s eGFR or glomerular filtration rate was less than 30 ml per minute they should not take NSAIDs to treat their aches and pains from RA because of the high risk of these medications exacerbating their already compromised kidney function.
The study included medicine from two different classes of NSAIDs, both the “coxib” and “rofecoxib” class. With this data it is safe to say that individuals with arthritic aches and pains can take NSAIDs without fear of kidney deterioration as long as they do not already have severe chronic kidney disease.
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