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NSAID use doesn’t explain high renal replacement prevalence in ethnic groups

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The disproportionate prevalence of UK patients from black and south Asian backgrounds on renal replacement programmes is not explained by differences in NSAID prescribing rates, according to new research.

The study used patient data from 12,011 patients who were registered to 102 general practices across Newham, City & Hackney and Tower Hamlets, to investigate whether variability in NSAID prescribing could explain the difference in prevalence amongst ethnic groups. Inclusion criteria were two or more eGFR values below 60ml/min/1.73m2 recorded in the previous two years. Ethnic categories were based on the UK 2011 census and were condensed into four groups for this study – white, black, south Asian and other. Data was extracted on history of oral NSAID prescription, number of daily doses of NSAIDs, and prescriptions of either paracetamol or PPIs.

The study found that there was no difference in the proportion of patients receiving an NSAID prescription amongst ethnic groups. South Asians and black patient groups were 66% less likely to be in the top decile of NSAID prescribing, a significant reduction, compared with white groups. 

The authors concluded that NSAID prescribing is ‘unlikely to be the cause of higher rates of black and south Asian patients on the renal replacement register’, or related to the more rapid progression of CKD in ethnic minorities.

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