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September/October 2011 Annals of Family Medicine Tip Sheet
Date:9/12/2011

reported by 2.5 percent, 2.5 percent and 5 percent of patients with no, mild, and moderate to severe CKD, respectively. Nearly all of the NSAIDs used were over-the-counter. Importantly, among those with moderate to severe CKD who were currently using NSAIDs, 10 percent had a current NSAID prescription, and 66 percent had used NSAIDs for more than one year. The authors note that NSAIDs have been associated both with acute kidney injury in the general population and with disease progression in those with CKD. As such, they recommend that primary care physicians, who are likely to manage both early-stage CKD and indications for NSAID use, be aware of the rates of NSAID use (both prescribed and over-the-counter), assess the risk of NSAID use in each patient, and most importantly, engage each patient in informed decision making about the risks and benefits of NSAID use.

Nonsteroidal Anti-Inflammatory Drug Use Among Persons With Chronic Kidney Disease in the United States
By Laura Plantinga, Sc. M., et al
University of California, San Francisco

Widely Used Coronary Disease Risk Prediction Models Fail to Accurately Predict Risk

Evaluating the performance of two long-established coronary disease risk scoring mechanisms, the original and REGICOR Framingham functions, researchers found one overestimates risk, whereas the other underestimates it. The 10-year observational study of 447 adult nondiabetic patients in Spain found the Framingham risk function overestimated coronary risk by 73 percent (by 48 percent in men and by 136 percent in women), whereas the REGICOR Framingham function underpredicted the population's coronary risk by 64 percent. Moreover, the original Framingham function selected a greater percentage of candidates for antihypertensive and lipid-lowering therapies than the REGICOR function (13 percent vs. 8 percent) and (14 percent vs. 7 percent), respectively. The proportion of patients included in the high c
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Contact: Angela Sharma
asharma@aafp.org
913-269-2269
American Academy of Family Physicians
Source:Eurekalert

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