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Table 2 Characteristics of included studiesa

From: Non-steroidal anti-inflammatory drug induced acute kidney injury in the community dwelling general population and people with chronic kidney disease: systematic review and meta-analysis

First Author, Year Design; Data; Country Inclusion Criteria Exclusion Criteria Participants Mean Age (yr) % Male Definition of NSAID use (exposure)b Definition of AKI (outcome) Adjusted OR (95%CI) for general population, plus crude OR for CKD pop if available
Bouvy 2003 [8] N-CC; PHARMO record linkage system; The Netherlands >40 years, with ≥2 consecutive prescription for an ACEI Hospitalisation with renal problems before start an ACEI 144 cases and 1189 controls Not reported (all >40 years) 63.9 cases;
45.4 controls
New/ start of ≥1 prescription in 3 months before hospital admission Hospitalisation ICD9 584 or 586 2.20 (1.10,4.50)
Huerta 2005 [34] N-CC; GPRD; UK 50–84 years, ≥2 years enrolment with GP and ≥1 year since first computerized prescription Cancer, renal disorder, cirrhosis, systemic connective tissue disease 386,916 individuals Not reported (all >50 years) Not reported Supply for the most recent prescription lasted until 0–30 days before index date Clinical diagnosis by a specialist, and SCr >1.7 mg/dl (150 μmol/L) or urea level >47.6 mg/dL (17.0 mmol/L) 3.23 (1.79,5.82)
Leonard 2012 [6] CC; GPRD; UK Not reported History of kidney transplant, having outcome of interest during baseline period 27,982 cases and 1,323,850 controls 68.6 cases;
66.9 controlsc
49.7 cases;
50.4 controls
Active orally administered tNSAID therapy Diagnostic codes described in succeeding texts supplemented by GP’s free-text 1.31 (1.25,1.37)
Murray 1990 [9] CC; Regenstrief Health Center; US >18 years, received ibuprofen or acetaminophen during 11May1975- 29Sept1986, baseline and post-prescription SCr and BUN results available Prescriptions of other NSAIDs, SCr < 0.3 mg/dL (30 μmol/L), BUN < 5 mg/dL (1.8 μmol/L) 4790 cases and 8205 controls Not reported 27.4 cases
N/A controls
Patients received first prescription of ibuprofen between 11May1975- 29Sept1986 Patients with normal baseline values, SCr >1.2 mg/dL (110 μmol/L) or BUN > 18 mg/dL (6.4 μmol/L);
Patients with elevated baseline values, SCr or BUN ≥10%increase
1.05 (0.88,1.26)
Perez Gutthann 1996 [36] CC; Saskatchewan health plan information; Canada ≥1 NSAID prescription during study period Malignant neoplasm, CRF, in-hospital disease onset, insufficient data, other systemic/ renal conditions 228,392 members Not reported 45.5 Most recent prescription filled 0–30 days before index ICD9 580.9, 581, 583.2, 583.6–583.9, 584, 586, 593.9 4.10 (1.50,10.8)
First Author, Year Design; Data; Country Inclusion Criteria Exclusion Criteria Study Sample Mean Age (yr) % Male Definition of NSAID use (exposure)b Definition of AKI (outcome) Adjusted OR (95%CI) for general population, plus crude OR for CKD pop if available
Evans 1995 [31] CC;MEMO; UK Resident in Tayside, Scotland registered with a Tayside GP in May 1990 Not reported 320 patients and 1238 community controlsd Not reported Not reported ≥1 oral NSAID prescriptions dispensed during 90 day period prior to the index date ICD9 583.8, 584.5, 584.7–584.9 2.20 (1.49,3.25); Crude OR for CKD population 3.04 (1.68,5.49)
Griffin 2000 [32] N-CC; Tennessee Medicaid enrolment files; US ≥65 years, enrolled in Medicaid ≥ 1 year End-stage renal disease, hospital-acquired acute renal failure, incomplete demographic data, remote counties residents 7145 patients and 10,000 controls Not reported (all ≥65 years) 31 cases; 23 controls Nonaspirin, supply of NSAIDs included index date An admission SCr ≥180 μmol/L (2 mg/dl) and ≥20% increase from baseline or ≥20% decline during hospitalization 1.58 (1.34,1.86); Crude OR for CKD population 1.80 (1.30, 2.50)
Schneider 2006 [37] N-CC; Quebec universal health care program database; Canada >65 years, filled ≥1 NSAID prescription during 01Jan1999-30June2002, NSAID prescription free ≥1 year before cohort entry Only use aspirin, renal replacement therapy, renal transplantation, 2 NSAIDs at cohort entry 121,722 new NSAID users 78.1 cases; 78.0 controls 46.1 cases; 32.3 controls Dispensed NSAID 1–30 days preceding the index date with no previous prescription ICD9 584, 586 2.05 (1.61,2.60); Crude OR for CKD population 1.13 (0.79, 1.62)
Lafrance 2009 [35] N-CC; Department of Veterans Affairs (VA) health care system; US ≥1 NSAID prescription during 01Oct2000-30Sept2006, NSAID prescription free 2 years before cohort entry History of renal transplantation, maintenance dialysis, or AKI before cohort entry 1,432,781 new NSAID users 63 (half >65 years) 97 Single NSAID dispensed day + 30 days tolerance period with no previous prescription Hospitalisation with AKI, AKIN definition 1.82 (1.68,1.98); Crude OR for CKD population 1.36 (1.30, 1.42)
Henry 1997 [33] Matched CC; John Hunter Hospital and Newcastle Master Hospital; Australia Admitted to study hospitals identified by hospital database Unfit for interview 164 cases and 189 controls 76.6 cases; 75.1 controls 55.5 cases;
55.0 controls
Any NSAID use in past month (excluding prophylactic aspirin) Admitted to hospitals with SCr ≥0.15 mmol/L 1.80 (0.97,3.40); Crude OR for CKD population
5.25 (1.06,26.07)
  1. aCC, case-control; N-CC, nested case-control; MEMO, Medicines Monitoring Unit’s record-linkage database; ICD9, International Classification of Disease version 9; AKIN, Acute Kidney Injury Network; ACEI, angiotensin-converting-enzyme inhibitor; GPRD, General Practice Research Database; SCr, serum creatinine; tNSAID, traditional NSAID; BUN, blood urea nitrogen; CRF, chronic renal failure
  2. bDefinition chosen by review authors
  3. cAge median (rather than mean)
  4. dThere are hospital controls which were ignored