Abstract
The clinical practice guideline by the Japanese Society of Nephrology in 2012 has recently recommended that patients with chronic kidney disease (CKD) should avoid non-steroidal anti-inflammatory drugs (NSAIDs) whenever possible. The purpose of this study was to investigate the prevalence of impaired kidney function and NSAID prescriptions in patients undergoing elective orthopaedic surgery in a university hospital.
A total of 241 adult patients (mean age 67 yr；range 24-92 yr) were included in the study. Impaired kidney function was defined as an estimated glomerular filtration rate (eGFR) of <60 mL/min/1.73m2. NSAIDs were prescribed mainly by orthopaedic residents and fellows for postoperative pain management.
Sixty-five patients (27%) had impaired kidney function preoperatively, and its prevalence increased significantly with age. In 39 (60%) of the 65 patients with impaired kidney function, NSAIDs were prescribed regularly for more than 5 days after surgery.
CKD is now recognized as a growing global public health problem. This study showed that a considerable number of patients undergoing elective orthopaedic surgery used NSAIDs regularly afterwards. Orthopaedic surgeons should be more aware of the potential risks associated with regular use of NSAIDs in patients with CKD.
