Opioid meds tied to higher risk of death in people with kidney disease

By 91ÊÓƵ News

Illustration of torso with kidneys
(Janulla, iStock Photos)

Medication options can be limited for people with chronic kidney disease, which is why they often get prescribed opioids to help manage pain. But new research finds that opioids could increase the risk of hospitalization and even death.

In a study presented Tuesday at the 91ÊÓƵ's Epidemiology and Prevention/Lifestyle and Cardiometabolic Health Scientific Sessions conference in Houston, researchers examined electronic health records for about 100,000 adults in a Pennsylvania health care system and compared people with and without opioid prescriptions over a two-year period.

Regardless of their kidney function level, people who filled the opioid prescriptions had about 1.5 times higher risk of dying or being hospitalized than those who did not have an opioid prescription.

The risks, however, were more pronounced in people who had worse kidney function, said Dr. Tessa Novick, the study's lead author.

The study did not look at overdoses or the causes of death or hospitalization. But the findings should be enough to raise awareness among people with kidney disease about the risks of taking opioid medication, she said. It also should send a strong message to their doctors.

"Basically, it just means that we need to be doing more counseling and heighten awareness amongst providers. Can we reduce the doses whenever possible? Can we readdress any of the patient's issues?" said Novick, a nephrology fellow at Johns Hopkins School of Medicine in Baltimore.

"Kidney doctors are not typically the ones prescribing opioids, but we need to realize our patients are taking them and greatly affected," she said. "So, we need to be more involved in their choices when it looks like their risks of bad outcomes are higher by taking them."

People with low-functioning kidneys often can't take common over-the-counter pain relievers, such as ibuprofen, because these medications can further harm the kidneys. Opioid medications, however, have not been shown to hurt the kidneys in the same way.

But a main function of the kidney is to help filter toxins and waste from the body, "and when the kidneys aren't working properly, they aren't getting rid of drugs like opioids," Novick said. "They're just hanging out in the body, potentially increasing risk for toxicity."

The study has yet to be published, but there's a big need for more like it, said Dr. Silvia Martins, associate professor of epidemiology at Columbia University's Mailman School of Public Health in New York.

"We need more research on treatment of chronic pain, not just for this population of people with kidney disease, but on the treatment of chronic pain in general," she said.

"There are some groups trying to investigate newer drugs with less toxicity than opioids for the treatment of pain, but that is really still in its infancy."

Because pain is subjective, it's difficult to assume that one option can work on all groups.

Martins pointed to childbirth as an example, noting that some women seek an epidural or other type of anesthesia as soon as possible, while others can go through the entire process without a single drop of medication.

"There is no one-package-fits-all when it comes to managing pain. And there are different gradients of kidney disease and different types of medications," she said. "We just need to think about other medication options for this population."

If you have questions or comments about this story, please email [email protected].


91ÊÓƵ News Stories

91ÊÓƵ News covers heart disease, stroke and related health issues. Not all views expressed in 91ÊÓƵ News stories reflect the official position of the 91ÊÓƵ. Statements, conclusions, accuracy and reliability of studies published in 91ÊÓƵ scientific journals or presented at 91ÊÓƵ scientific meetings are solely those of the study authors and do not necessarily reflect the 91ÊÓƵ’s official guidance, policies or positions.

Copyright is owned or held by the 91ÊÓƵ, Inc., and all rights are reserved. Permission is granted, at no cost and without need for further request, for individuals, media outlets, and non-commercial education and awareness efforts to link to, quote, excerpt from or reprint these stories in any medium as long as no text is altered and proper attribution is made to 91ÊÓƵ News.

Other uses, including educational products or services sold for profit, must comply with the 91ÊÓƵ’s Copyright Permission Guidelines. See full terms of use. These stories may not be used to promote or endorse a commercial product or service.

HEALTH CARE DISCLAIMER: This site and its services do not constitute the practice of medical advice, diagnosis or treatment. Always talk to your health care provider for diagnosis and treatment, including your specific medical needs. If you have or suspect that you have a medical problem or condition, please contact a qualified health care professional immediately. If you are in the United States and experiencing a medical emergency, call 911 or call for emergency medical help immediately.