ith kidney failure, but opioid medication prescriptions are associated with morbidity and mortality. The Centers for Disease Control and Prevention issued opioid prescription guidelines in 2016 and 2022, associated with dramatically decreased prescription rates in the United States. It is critical to know whether nationwide opioid prescription rates for patients with kidney failure have decreased. Methods We analyzed the United States Renal Data System database from 2011 to 2020 to describe trends in the proportion of patients with ESKD who received one or more, or long-term, opioid prescriptions, examined factors associated with long-term opioid prescriptions, and evaluated associations of all-cause death with short-term or long-term opioid prescriptions. Results From 2011 to 2022, the percentage of patients with kidney failure (dialysis and kidney transplant) who received at least one or more, or who had received long-term, opioid medication prescriptions decreased steadily, from 60% to 42%, and from 23% to 13%, respectively (both P for trend < 0.001). The largest reductions in prescription rates were for hydrocodone and oxycodone. Similar trends existed for dialysis and kidney transplant patients. Women, the poor, and those in rural settings were more likely to receive long-term opioid prescriptions. Prescription rates were highest in White patients and those aged 45–64 years. Short-term and long-term opioid medication prescriptions were associated with higher mortality in both dialysis and kidney transplant patients. Conclusions The opioid prescription rates of patients with ESKD decreased between 2011 and 2020. Higher mortality risk was associated with both short-term and long-term opioid prescriptions. Mortality risk was monotonically associated with morphine milligram equivalents in patients with kidney failure who received long-term opioid prescriptions....

中文翻译：

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2011 年至 2020 年接受长期透析或肾移植的美国患者的阿片类药物处方


i 肾功能衰竭，但阿片类药物处方与发病率和死亡率相关。美国疾病控制和预防中心在 2016 年和 2022 年发布了阿片类药物处方指南，与美国处方率的急剧下降有关。了解全国肾衰竭患者的阿片类药物处方率是否下降至关重要。方法 我们分析了 2011 年至 2020 年的美国肾脏数据系统数据库，以描述接受一种或多种或长期阿片类药物处方的 ESKD 患者比例的趋势，检查了与长期阿片类药物处方相关的因素，并评估了全因死亡与短期或长期阿片类药物处方的关联。结果 从 2011 年到 2022 年，接受至少一种或多种或接受过长期阿片类药物处方的肾功能衰竭 （透析和肾移植） 患者的百分比稳步下降，分别从 60% 下降到 42%，从 23% 下降到 13%（趋势 < 0.001 的 P 均 P）。处方率降幅最大的是氢可酮和羟考酮。透析和肾移植患者也存在类似的趋势。妇女、穷人和农村地区的人更有可能接受长期阿片类药物处方。白人患者和 45-64 岁患者的处方率最高。短期和长期阿片类药物处方与透析和肾移植患者的较高死亡率相关。结论 2011 年至 2020 年期间，ESKD 患者的阿片类药物处方率有所下降。较高的死亡风险与短期和长期阿片类药物处方相关。 在接受长期阿片类药物处方的肾功能衰竭患者中，死亡风险与吗啡毫克当量单调相关。