• Sally Hull, Rohini Mathur, Gavin Dreyer, and Muhammad Magdi Yaqoob.
• Centre for Primary Care and Public Health, Queen Mary, University of London, London, UK.
• Br J Gen Pract. 2014 Jul 1; 64 (624): e448e455e448-55.

BackgroundThe public health burden of chronic kidney disease (CKD) and end-stage kidney disease is a national priority and is the subject of recent guidelines. In the UK, ethnic minority groups are over-represented in the renal replacement population (17.8%) compared with the white population (11%).AimNon-steroidal anti-inflammatory drugs (NSAIDs) are a preventable cause of renal damage. Previous studies suggest a prescribing prevalence between 9% and 36% among those with CKD, but have not examined differences by ethnic group.Design And SettingCross-sectional survey of 12 011 patients with identified CKD (stages 3-5) in the three PCTs of Tower Hamlets, Hackney, and Newham.MethodAssessment of NSAID prescribing rates in a multi-ethnic, socially-deprived population, using descriptive and multivariate analysis.ResultsNSAIDs were prescribed for 11.1% of patients with CKD in the year prior to November 2012. Prescribing rates decreased stepwise by stage of renal impairment. Using daily defined dosages this study shows that in comparison with white groups both South Asian and black groups are much less likely to be in the top decile of NSAID prescribing, hence the overall prescribing load will be less: (odds ratio [OR] for South Asians = 0.34, 95% confidence interval [CI] = 0.22 to 0.54, OR for black groups = 0.34, 95% CI = 0.19 to 0.63).ConclusionNational rates of NSAID prescribing continue to rise, and over-the-counter sales remain unmonitored, despite longstanding concerns about renal outcomes. Prescribing patterns indicate that GPs reduce prescribing as CKD progresses. Differential use of NSAIDs by ethnic group is unlikely to contribute to the high rates of end-stage kidney disease in ethnic minority groups.© British Journal of General Practice 2014.

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