Chronic Kidney Disease

Are Patients With CKD More Likely to Use Opioids?

Prescription opioid use is more common among patients with chronic kidney disease (CKD) compared with members of the general population, according to new findings presented at the American Society of Nephrology’s Kidney Week 2018.

In the age of the US opioid epidemic, these findings are likely not surprising, given the high prevalence of pain and frequent contact with healthcare systems among patients with CKD.

Daniel P Murphy, MD, and Robert N Foley, MD, of the University of Minnesota in Minneapolis, came to this conclusion following their analysis of trends in prescription opioid use from 1999 to 2014, using National Health and Nutrition Examination Survey data.

Participants with a creatinine-based estimated glomerular filtration rate (eGFR) of less than 60 ml/min/1.73m2 or an albumin-creatinine ratio (ACR) of at least 30 mg/g were included in the study.

Any differences in opioid use based on racial/ethnic or other demographic factors and CKD-related comorbidities were also taken into account.

Ultimately, the researchers found that 7.5% of patients with CKD used a prescription opioid compared with 5.4% of patients without CKD.

Factors that were associated with opioid use included:

  • Reduced eGFR (8.4% in patients with reduced eGFR vs 5.6% in patients without reduced eGFR)
  • Albuminuria (7.4% in those with albuminuria vs 5.6% in those without albuminuria)
  • The era of 2011 to 2014 (compared with 1999 to 2002 in an adjusted model; adjusted odds ratio 1.43)
  • Age 40 to 64 years
  • Female sex
  • Diabetes
  • Hypertension
  • A body mass index of at least 30 kg/m2
  • History of cancer
  • Arthritis

 

No temporal trend in the unadjusted prevalence of opioid use was observed among patients with CKD.

“Prescription opioid use is more prevalent among the CKD population than in the general US population with 28% of opioid use among those with CKD attributable to the association with CKD,” the researchers wrote.

“Multiple comorbidities, which to varying degrees increase risk for pain and/or exposure to healthcare systems, were associated with increased prevalence of prescription opioid use,” they concluded.

—Christina Vogt

Reference:

Murphy DP, Foley RN. Trends in use of prescription opioids by those with CKD in the United States, 1999 to 2014. Paper presented at: American Society of Nephrology 2018 Annual Scientific Meeting; October 23-28, 2018; San Diego, CA.