MANIFESTATIONS OF NON-STEROIDAL ANTI-INFLAMMATORY DRUGS-INDUCED KIDNEY DISORDERS

Abstract

INTRODUCTION

Non-steroidal anti-inflammatory drugs (NSAIDs) are one of the most commonly prescribed medication.¹ The gastrointestinal tract and kidneys are important targets of clinical events associated with the use of NSAIDs.² Selective COX-2 inhibitors have minimal gastrointestinal side effects. However, the newer NSAIDs also has nephrotoxic effects remain as nonselective NSAIDs.¹

The kidneys are the major organ for drug excretion, so that the renal arterioles and glomerular capillaries are especially vulnerable to the effects of drugs. ³ The spectrum of NSAID-induced nephrotoxicity includes acute tubular necrosis, acute tubulointerstitial nephritis, glomerulonephritis, renal papillary necrosis, chronic renal failure, salt and water retention, hypertension, and hyperkalemia. ¹

Among the various clinical complications, the effects on the kidney are probably the most common and severe due to the use of NSAIDs.⁴ Fifty million US citizens report NSAIDs use, and it has been estimated that 500.000 – 2,5 million people will develop NSAID nephrotoxicity in the US annually. ⁵ It has been reported that 37% of drug-associated acute renal failure is associated with the use of NSAIDs, and NSAID-induced acute renal failure accounts for 7% of overall cases of acute renal failure. ⁴

This review discusses the NSAIDs, mechanisms and clinical manifestations of NSAID-induced renal impairment and some NSAID options that can be used in patients with renal failure.