Kidney Week

Abstract: PUB495

Nonsteroidal Anti-inflammatory Drug (NSAID) Prescriptions in Living Kidney Donors

Session Information

• Publication Only

Category: Transplantation

• 2102 Transplantation: Clinical

Authors

• Laube, Mikayla, University of Calgary, Calgary, Alberta, Canada

Mikayla Laube, MD

• Quinn, Robert R., University of Calgary, Calgary, Alberta, Canada

Robert R. Quinn, MD, PhD

• Ravani, Pietro, University of Calgary, Calgary, Alberta, Canada

Pietro Ravani, MD, PhD

• Lentine, Krista L., Saint Louis University, St Louis, Missouri, United States

Krista L. Lentine, MD, PhD, FASN

• Jeong, Rachel, University of Calgary, Calgary, Alberta, Canada

Rachel Jeong, MD

• Lam, Ngan, University of Calgary, Calgary, Alberta, Canada

Ngan Lam, MD, MSc

Background

Current guidelines recommend that living kidney donors should avoid non-steroidal anti-inflammatory drugs (NSAIDs) due to their potential nephrotoxic effects. It is unclear if physicians are adhering to this guideline recommendation.

Methods

We conducted a population-based, retrospective cohort study of adult living kidney donors in Alberta, Canada, who donated between 2002 and 2019. We identified the proportion of living kidney donors who filled an NSAID prescription at least 1-year beyond date of donation. Of those donors who were prescribed an NSAID, we assessed how many underwent post-prescription laboratory testing for kidney function and potassium within 14 days.

Results

Of 759 living kidney donors in the study cohort, 273 (36%) had at least one NSAID prescription over a median follow up of 7.2 years (IQR 3.5-11.5). Donors with at least one NSAID prescription were more likely to be from lower socio-economic status, have an earlier donation date, have higher pre-donation eGFR, and have co-morbid gout and osteoarthritis at the index date. The proportion of donors with at least one prescription in follow-up remained stable over time (~10% per year). Family physicians accounted for 66% of all NSAID prescriptions. Of the donors with an NSAID prescription, 30% also filled at least one prescription for an opioid. Approximately, 10% of donors had measurements of serum creatinine or potassium within 14 days of the first NSAID prescription. The risk of acute kidney injury or hyperkalemia was uncommon in those that underwent laboratory testing (6% and 3% respectively).

Conclusion

Over one-third of living kidney donors are prescribed NSAIDs despite current guideline recommendations. Few donors had evidence of post-prescription laboratory testing, but adverse outcomes were uncommon in those who were tested. Further research assessing outcomes following NSAID use is recommended to better inform guidelines for living kidney donors.