OBJECTIVES: To examine the relationship between NSAID use and the progression of CKD for a cohort of elderly patients within the military health system.  METHODS: All patients with at least one serum creatinine measurement in each of the time periods July 1–December 31, 2006 and July 1–December 31, 2008 with a baseline estimated glomerular filtration rate (eGFR) representing CKD stage 2 or 3, who were ≥ 67  years of age, continuously eligible for TRICARE, and received care at a military treatment facility were included in a retrospective database analysis.  Logistic regression analyses were used to explore associations between NSAID use and rapid progression of CKD defined as a decrease in eGFR of ≥ 15 mL/min/1.73m2.  Covariates included age, gender, diabetes, hyperlipidemia, hypertension, and NSAID exposure level.  RESULTS: A total of 34,295 patients (median age 73.5, 50.2% male) met the inclusion/exclusion criteria. A total of 14,576 patients had some NSAID use, while 19,719 had no NSAID use.  Rapid CKD progression occurred for 10.5% of no use NSAID patients (2,063 of 19,720), 11.2% of low to medium NSAID use patients (1,465 of 13,125), and 13.4% of high NSAID use patients (195 of 1,450).  Logistic regression results showed that stage 2-3 CKD patients with low to medium NSAID use did not have an increased risk (stage 2 OR 1.002, CI 0.925-1.086; stage 3 OR 0.936, CI 0.782-1.122) of rapid CKD progression compared to the no NSAID exposure group.  Stage 2-3 CKD patients with high NSAID use trended toward, but did not achieve a statistically significant increased risk (stage 2 OR 1.185, CI 0.994-1.413; stage 3 OR 1.276, CI 0.844-1.927) of rapid CKD progression.  CONCLUSIONS: NSAID exposure over a two year period was not associated with an increased risk of renal dysfunction in our cohort of elderly patients with either stage 2 or 3 CKD.