Migraine and subsequent chronic kidney disease risk: a nationwide population-based cohort study

BMJ Open. 2017 Dec 27;7(12):e018483. doi: 10.1136/bmjopen-2017-018483.

Abstract

Objective: We compared the incidence and risk of chronic kidney disease (CKD) between subjects with new-onset migraine and matched controls without migraine in this large-scale retrospective cohort study.

Design: Population-based cohort study.

Setting: 8880 subjects with migraine and 503 070 subjects without migraine were enrolled between January 1, 2000 and December 31, 2013, all diagnosed to be without kidney disease. All the participants were registered in the National Health Insurance Research Database.

Participants: Finally, data from 7156 subjects with migraine and 7156 propensity-score-matched control subjects were analysed.

Primary outcome measure: We used Cox proportional hazards regression to estimate adjusted HRs for incident CKD; subgroup analyses were performed to assess the interactive effects of migraine with demographics, comorbidities and long-term medications.

Results: The incidence of CKD was higher in the migraine group than in the control group. The risk of developing CKD was significantly higher in subjects with migraine than without migraine (P=0.031). Subjects with migraine aged <65 years (age 40-64 (adjusted HR (aHR) 1.35; 95% CI 1.05 to 1.73); age <40 (aHR 1.55; 95% CI 1.02 to 2.36)), with ≥1 comorbid diseases (1-2 diseases (aHR 1.30; 95% CI 1.01 to 1.68); ≥3 diseases (aHR 1.45; 95% CI 1.01 to 2.07)), and not receiving anti-migraine agents (aHR 1.26; 95% CI 1.04 to 1.54) were at a higher risk of developing CKD compared with the control subjects. The interaction between migraine and comorbidities was not significant; age, male gender and long-term use of non-steroidal anti-inflammatory drugs (NSAIDs) were independent risk factors for CKD in subjects with migraine.

Conclusion: Migraine may be an independent risk factor for CKD. Young subjects with migraine, and those with comorbid conditions or without medical control, are likely to be at higher risk for CKD. Ageing, male sex and NSAIDs tend to have an association with CKD in subjects with migraine.

Keywords: anti-migraine agents; chronic kidney disease; migraine; national health insurance research database; propensity score.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Distribution
  • Aged
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Case-Control Studies
  • Comorbidity
  • Female
  • Humans
  • Incidence
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Migraine Disorders / complications*
  • Migraine Disorders / drug therapy
  • Migraine Disorders / epidemiology*
  • Propensity Score
  • Proportional Hazards Models
  • Renal Insufficiency, Chronic / epidemiology*
  • Retrospective Studies
  • Risk Factors
  • Sex Distribution
  • Taiwan / epidemiology

Substances

  • Anti-Inflammatory Agents, Non-Steroidal