{"id":"b5f510f9ffc8","type":"article","url":"https://hartvaat.nl/2026/12/01/langdurig-opioid-en-gabapentinoidegebruik-verhoogt-sterfte-en-ziekenhuisopnames-/","title":"Langdurig opioid- en gabapentinoïdegebruik verhoogt sterfte en ziekenhuisopnames bij CKD","title_en":"Long-Term Opioid and Gabapentinoid Related Harms in CKD.","category":"chronische nierziekte","category_label":"Nierziekte","professions":["apotheker","huisarts","internist"],"tags":[],"journal":"Kidney international reports","doi":"10.1016/j.ekir.2026.107085","source_url":"https://doi.org/10.1016/j.ekir.2026.107085","authors":["Christopher H Grant","Shona Livingstone","Huan Wang","Karen N Barnett","Patrick B Mark","Lesley A Colvin","Samira Bell"],"significance":6,"published":"2026-10-30","source_date":"2026-12-01","image":"","kennis":["https://hartvaat.nl/kennis/nierziekte/nierziekte-en-cardiovasculair-risico/","https://hartvaat.nl/kennis/nierziekte/nsaids-en-nierziekte/"],"congress":"","summary_en":"A retrospective population-based cohort study of over 21,000 adults with chronic kidney disease (CKD) without kidney failure found that long-term use of opioids and gabapentinoids is associated with increased mortality and hospitalization. The risk of death rose in a dose-dependent manner, with patients experiencing six consecutive 90-day opioid treatment periods facing a 1.68-fold higher mortality risk compared to non-users, while gabapentinoids showed only a modest mortality increase in men. These findings highlight the importance of cautious prescribing and prioritizing safer pain management alternatives for patients with CKD.","created":"2026-10-24T00:48:44Z","updated":"2026-10-24T00:48:44Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Een retrospectieve cohortstudie onder ruim 21.000 volwassenen met chronische nierziekte (CKD) zonder nierfalen toont aan dat langdurig gebruik van opioiden en gabapentinoïden gepaard gaat met een verhoogd risico op sterfte en ziekenhuisopnames. Het sterfterisico stijgt dosisafhankelijk: patiënten met zes opeenvolgende periodes van 90 dagen opioidgebruik hadden een 1,68 keer hoger risico op overlijden vergeleken met niet-gebruikers, terwijl gabapentinoïden alleen bij mannen een bescheiden risicotoename lieten zien. Deze bevindingen onderstrepen de noodzaak van een zorgvuldige afweging en het prioriteren van veiligere pijnbestrijdingsstrategieën in deze kwetsbare patiëntengroep.","abstract_original":"INTRODUCTION: Chronic pain affects over half of the patients with chronic kidney disease (CKD). This study aimed to evaluate the association between new long-term opioids or gabapentinoids and the risk of death, hospitalization, and hip fractures in adults with CKD. METHODS: This is a retrospective, time-updated, population-based cohort study from the East of Scotland (N = 953,542) using linked routinely collected data. The study population included adults with biochemically confirmed CKD (estimated glomerular filtration rate [eGFR] <60 ml/min per 1.73 m2) without kidney failure from 2010 to 2023. The primary exposures were new, long-term cumulative opioids or gabapentinoids. Discrete time logistic regression modelling with generalized estimating equations and adjustment for relevant covariates and treatment allocation bias was used to determine the association between chronic analgesic use and all-cause mortality. RESULTS: A total of 30,674 adults with CKD entered the study. Of them, 21,440 patients without prevalent analgesic use were included in the primary and secondary analyses (median follow-up 4.3 years). Among 2399 patients with at least 1 continuous 90-day episode of opioid prescriptions during follow-up, 1159 died. The risk of death increased as continuous 90-day opioid stretches (reference 0) increased from 1 (absolute risk of death: 0.4% [0.3-0.4]; odds ratio [OR]: 1.09 [1.06-1.12], P < 0.001) to 6 (absolute risk of death: 0.6% [0.5-0.7]; OR: 1.68 [1.41-2.00], P < 0.001). Long-term gabapentinoids were potentially associated with a modest increase in death amongst males (OR: 1.04 [1.00-1.08], P = 0.050), but not females (OR: 1.02 [0.99-1.05], P = 0.201). CONCLUSION: Long-term opioid use is associated with increased mortality and hospitalization in adults with CKD independent of demographics, comorbidities, and treatment allocation bias. These findings support prioritization of safer pain management strategies in people with CKD."}