Zhan M, Doerfler RM, Xie D, et al. - Researchers undertook this prospective cohort analysis to compare harm from opioids vs nonsteroidal anti-inflammatory drugs (NSAIDs) in chronic kidney disease (CKD). Participants were 3,939 CKD cases in the Chronic Renal Insufficiency Cohort (CRIC) Study. A composite outcome of 50% glomerular filtration rate decrease and kidney failure needing kidney replacement therapy (KRT) was assessed, along with the outcomes of kidney failure needing KRT, hospitalization, and pre–kidney failure mortality. A median follow-up of 6.84 years revealed the link of time-updated opioid use with the kidney disease composite outcome, kidney failure with KRT, mortality, and hospitalization vs opioid nonusers. Similar findings were identified in a study restricted to a subcohort of participants stating ever using other (nonopioid and non-NSAID) analgesics or tramadol. Overall, a stronger association of opioid use, vs NSAIDs, with adverse events was revealed, with the latter’s link with kidney disease outcomes restricted to particular subgroups, notably those of black race.