Knowledge and Preventive Practices Regarding Nonsteroidal Anti-inflammatory Drug (NSAID)-Induced Kidney Injury Among Chronic Users in Jordan: A Cross-Sectional Study.

Background Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used for acute and chronic pain. However, inappropriate use is a well-established risk factor for kidney injury. Community awareness and preventive practices among chronic users remain unclear. This study aimed to assess knowledge and preventive practices regarding NSAID-induced kidney injury among chronic NSAID users and to examine the association between these two domains. Methods A cross-sectional study was conducted (November-December 2025) using an anonymous online questionnaire distributed via social media. Adults (≥18 years) with chronic pain reporting regular NSAID use were eligible. Knowledge (0-6) and preventive practice (0-12) scores were calculated. The association was evaluated using Kendall's tau-b. Results Among 300 participants, the mean knowledge score was 3.97 ± 1.24 (95% CI: 3.83-4.11), and the mean practice score was 8.54 ± 2.15 (95% CI: 8.30-8.78). The most deficient knowledge item was awareness of asymptomatic kidney injury (51.3% correct). The weakest preventive practices were reading medication leaflets (54.0% reporting "Always") and avoiding NSAIDs during dehydration (56.7% reporting "Always"). A significant positive association was observed between knowledge and practice scores (τ = 0.317, p < 0.001). Conclusion Knowledge is significantly associated with safer NSAID use. Targeted education, particularly regarding asymptomatic injury, hydration, and leaflet reading, may reduce preventable renal harm. Pharmacist-led counseling at the point of sale is a recommended action.