Kidney Disease: A Risk Factor for Opioid Use

Findings Suggest Targets for Improvement in Risk Assessment and Prescribing Practice

Findings from a recent study slated for presentation last week at ASN Kidney Week 2018, San Diego conclude that patients with chronic kidney disease (CKD) are more likely to use opioids than individuals without kidney conditions, and that this propensity has increased in recent years. Lead author Daniel Murphy, MD, with the University of Minnesota, commented, “Our research suggests the need for further work investigating the indications for opioid prescribing and the outcomes associated with use of prescription opioids in those with CKD.” The findings were derived from an analysis of data on patients with CKD who participated in the National Health and Nutrition Examination Survey and covered a time period from 1999 to 2014.

Across the data interval, 7.5% of adults with CKD were found to have had an active opioid prescription, vs 5.4% of adults without CKD. Higher prescription opioid use was associated with older age and in women, although no other race/ethnicity correspondence was noted. Propensity for opioid use was higher in patients with multiple comorbid conditions including both painful (cancer, arthritis) and nonpainful (hypertension, obesity, diabetes) presentations. There was also a higher prevalence of opioid use in patients with CKD in the years 2011 to 2014 as compared to the 1999 to 2002 interval. Other environmental/geographic factors that were positively associated with opioid use in elderly patients with CKD included areas in the west or south, locations that were medically underserved, and patients classified as having a higher deprivation index. Coauthor Yun Han, MD, concluded, “The environmental factors identified in our study may be helpful for healthcare providers to target CKD patients at high risk of opioid abuse/dependence, and for designing local regulation and treatment for appropriate opioid use in CKD patients.”

Read more about the study findings.

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