Nonsteroidal anti-inflammatory drug-associated azotemia in the very old.

UMMS Affiliation

Meyers Primary Care Institute; Department of Medicine

Publication Date


Document Type



Aged; Aged, 80 and over; Analysis of Variance; Anti-Inflammatory Agents, Non-Steroidal; Blood Urea Nitrogen; Electrolytes; Humans; Institutionalization; Logistic Models; Prospective Studies; Risk Factors; Uremia


Health Services Research | Medicine and Health Sciences


We conducted a prospective study in 114 elderly patients to determine the renal effects of short-term therapy with nonsteroidal anti-inflammatory drugs (NSAIDs) in the very old. Study subjects were patients in a long-term care facility (mean age, 87 years) newly begun on a regimen of NSAID therapy. For the study group as a whole, the serum urea nitrogen level rose 1.7 mmol/L 5 to 7 days after initiation of therapy, with no significant changes in serum creatinine or potassium levels. In a comparison group of 45 patients not receiving NSAID therapy, no significant change in the serum urea nitrogen level was noted during a similar period. A subgroup of 15 patients (13%) experienced a greater than 50% increase in the serum urea nitrogen level during NSAID therapy, with a mean increase of 89% (8.6 mmol/L). A return to the baseline level occurred within 14 days after discontinuation of NSAID therapy. Two factors were significantly predictors of a greater than 50% increase in the serum urea nitrogen level: concurrent loop diuretic therapy (odds ratio, 2.2) and high NSAID dose (odds ratio, 2.0). These findings suggest that reversible azotemia develops in a sizable proportion of the very old who are treated with short-term NSAID therapy.


JAMA. 1990 Jul 25;264(4):471-5.

Journal/Book/Conference Title

JAMA : the journal of the American Medical Association

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Link to article in PubMed

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