{"doi":"10.34067/kid.0003682020","title":"Renal Safety of Nonsteroidal Anti-Inflammatory Drugs and Opioids in Hospitalized Patients on Renin-Angiotensin System Inhibitors","abstract":"Nonsteroidal anti-inflammatory drug (NSAID) prescriptions for analgesia during hospitalization are increasing as health systems implement opioid-minimization initiatives (1). This trend can lead to an increase in the use of alternative agents, including NSAIDs, which are known to cause or increase susceptibility to hemodynamically mediated AKI among other renal adverse events. The risk for these outcomes may be particularly high among patients with multiple comorbidities and who are acutely ill (2). This may be especially true when NSAIDs are prescribed concurrently with renin-angiotensin-aldosterone inhibition (RAASi), which may reduce the threshold for hemodynamically mediated AKI, especially among those with actual or effective volume depletion or with decreased systemic vascular resistance. The higher risk with this drug-drug interaction is known and well documented in the outpatient setting (2,3); however, this study is the first to evaluate the potential and the magnitude for synergistic nephrotoxicity of NSAIDs and RAASi agents in patients who are hospitalized.\n\nIn this study, the authors conducted a large-scale pharmacoepidemiologic study in 25,571 hospitalized patients admitted to four hospitals in Pennsylvania to evaluate the risk of AKI in patients that are prescribed NSAIDs concurrently with RAASi therapy. They used advanced and rigorous methods to control for confounders. One of these approaches is the use of an active comparator (drugs with similar clinical indication), which allows to control for confounding by indication (4). For NSAIDs, the active comparator …","journal":"Kidney360","year":2020,"id":130510,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9505,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":273407,"name":"Cecilia P. Chung","orcid":"0000-0001-5908-9423","position":1,"is_corresponding":false},{"id":11400,"name":"Adriana M. Hung","orcid":"0000-0002-3203-1608","position":0,"is_corresponding":true}],"reference_count":12,"raw_metadata":null,"created_at":"2026-07-18T23:15:56.698770Z","pmid":"35372946","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}