====== Risk of acute kidney injury between conventional NSAIDs and selective COX-2 inhibitors ======

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**Objective:** To compare the risk of acute kidney injury between conventional nonsteroidal anti-inflammatory drugs (NSAIDs) and selective cyclooxygenase-2 (COX-2) inhibitors.

**Rationale:** NSAIDs are most commonly used class of medication worldwide. NSAIDs are often associated with adverse drug events including renal toxicity. 
In states of reduced renal blood flow, adequate glomerular filtration rate may be dependent on afferent arteriole dilatation mediated by prostaglandins. Nonspecific Inhibition of COX-mediated renal prostaglandins synthesis would then remove this compensatory mechanism and increase the risk of kidney injury. The hypothesis of COX-1-sparing COX-2 inhibition underlying development of COX-2 inhibitors is that anti-inflammatory and analgesic efficacy can be achieved without deleterious effects on gastrointestinal, platelet, and possibly renal function.
Early studies suggested that selective COX-2 inhibitors caused fewer renal adverse effects including reduction in glomerular filtration rate, increased serum creatinine and hypertension. However, other studies have shown no significant differences in renal risk between selective COX-2- inhibitors and conventional NSAIDs. Therefore, the aim of this study is to compare the risk of acute kidney injury between selective COX-2 inhibitor and conventional NSAIDs in the large population.

**Project Lead(s):** Ji In Park, MD, Kangwon National University Hospital, Korea;
Seng Chan You, MD, Ajou University, Korea

**Coordinating Institution(s):** Ajou University; Kangwon National University Hospital

** Additional Participants:**  

**Full Protocol:** 

**Initial Proposal Date:**  8th Jan 2018

**Launch Date:**  

**Study Closure Date:  **

**Results Submission:** applegna@gmail.com

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===== Requirements =====
**CDM:** V5

**Table Accessed:**  person, condition, drug, procedure, measurement

**Database Dialects:** Any that SqlRender provides

**Software:**  R
 
===== Code ===== 
[[https://github.com/OHDSI/StudyProtocolSandbox/tree/master/NSAIDsVsCoxib_AKI]]

===== Discussion ===== 
//Post a thread letting everyone know about this new proposed study at [[]]// 

===== Datasets Run ===== 
  * AUSOM
  * NHIS-CDM


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