Adverse Effects of Nonsteroidal Anti-inflammatory Drugs on Renal Function

Editorials15 April 1990Adverse Effects of Nonsteroidal Anti-inflammatory Drugs on Renal FunctionMichael D. Murray, PharmD, D. Craig Brater, MDMichael D. Murray, PharmD, D. Craig Brater, MDAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-112-8-559 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptA number of clinical conditions, including congestive heart failure, cirrhosis, and renal insufficiency, require local synthesis of vasodilating prostaglandins to maintain renal perfusion (for review,see1-3). When patients with these disorders receive nonsteroidal anti-inflammatory drugs (NSAIDs), they are at risk for an acute ischemic insult to the kidney because inhibition of these prostaglandins allows unopposed vasoconstriction to occur. Numerous interventional (as opposed to epidemiologic) studies have been done that incorporate study designs generally similar to that reported by Whelton and colleagues in this issue (4). The collective results of such studies show that a large proportion of patients preselected...References1. CliveStoff DJ. Renal syndromes associated with nonsteroidal antiinflammatory drugs. N Engl J Med. 1984;310:563-72. CrossrefMedlineGoogle Scholar2. Brater D. Clinical aspects of renal prostaglandins and NSAID therapy. Semin Arthritis Rheum. 1988;17(Suppl 2):17-22. CrossrefMedlineGoogle Scholar3. StillmanSchlesinger MP. Nonsteroidal anti-inflammatory nephrotoxicity: should we be concerned? Arch Intern Med. 1990;150:268-70. CrossrefMedlineGoogle Scholar4. WheltonStoutSpilmanKlassen ARPD. Renal effects of ibuprofen, piroxicam, and sulindac in patients with asymptomatic renal failure. A prospective, randomized, crossover comparison. Ann Intern Med. 1990;112:568-76. LinkGoogle Scholar5. Squire S. Painkiller safety questioned: high doses of ibuprofen linked to kidney damage, new studies say. Washington Post. 6 Feb 1990. Google Scholar6. BraterAndersonBairdCampbell DSBW. Effects of ibuprofen, naproxen, and sulindac on prostaglandins in men. Kidney Int. 1985;27:66-73. CrossrefMedlineGoogle Scholar7. Statement on the release of ibuprofen as an over-the-counter medicine. Ad Hoc Committee for the National Kidney Foundation [Editorial]. Am J Kidney Dis. 1985;6:4-6. CrossrefMedlineGoogle Scholar8. Lawson D. Analgesic consumption and impaired renal function. J Chronic Dis. 1973;26:39-45. CrossrefMedlineGoogle Scholar9. FoxJick DH. Nonsteroidal anti-inflammatory drugs and renal disease. JAMA. 1984;251:1299-300. CrossrefMedlineGoogle Scholar10. JohnsonJickHunterDickson JHJJ. A followup study of ibuprofen users. J Rheumatol. 1985;12:549-52. MedlineGoogle Scholar11. BonneyNorthingtonHedrichWalker SRDB. Renal safety of two analgesics used over the counter: Ibuprofen and aspirin. Clin Pharmacol Ther. 1986;40:373-7. CrossrefMedlineGoogle Scholar12. BeardPereraJick KDH. Drug-induced parenchymal renal disease in outpatients. J Clin Pharmacol. 1988;28:431-5. CrossrefMedlineGoogle Scholar13. DahlWard SJ. Efficacy and tolerability of oxaprozin in the elderly. Semin Arthritis Rheum. 1986;15(Suppl 2):40-6. CrossrefGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: Michael D. Murray, PharmD; D. 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