Adverse renal effects of anti-inflammatory agents: evaluation of selective and nonselective cyclooxygenase inhibitors

J Intern Med. 2003 Jun;253(6):643-52. doi: 10.1046/j.1365-2796.2003.01146.x.

Abstract

Conventional nonsteroidal anti-inflammatory drugs (NSAIDs), i.e. nonselective cyclooxygenase COX inhibitors have well-documented nephrotoxicity. Adverse renal effects occur because of inhibition of the synthesis of cyclooxygenase-derived prostaglandins which act to modulate pathologic processes that would normally impair various renal functions. The introduction of the selective COX-2 inhibitors raised hope that this class of drugs would reduce injury in both the gastrointestinal tract and the kidneys. Animal and human data, however, suggest that COX-2 synthesized prostaglandins are important in the modulation of renal physiology during adverse conditions. Hence, it appears that these drugs are equal in causing nephrotoxicity as the nonselective COX inhibitors.

Publication types

  • Review

MeSH terms

  • Acute Kidney Injury / chemically induced*
  • Acute Kidney Injury / metabolism
  • Acute Kidney Injury / physiopathology
  • Animals
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects*
  • Anti-Inflammatory Agents, Non-Steroidal / metabolism
  • Contraindications
  • Cyclooxygenase 2
  • Cyclooxygenase 2 Inhibitors
  • Cyclooxygenase Inhibitors / adverse effects*
  • Cyclooxygenase Inhibitors / metabolism
  • Edema / metabolism
  • Glomerular Filtration Rate / drug effects
  • Humans
  • Hypertension, Renal / chemically induced
  • Hypertension, Renal / metabolism
  • Isoenzymes / metabolism
  • Kidney / drug effects*
  • Kidney / metabolism
  • Kidney / physiopathology
  • Leukotrienes / metabolism
  • Membrane Proteins
  • Prostaglandin-Endoperoxide Synthases / metabolism
  • Prostaglandins / metabolism

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Cyclooxygenase 2 Inhibitors
  • Cyclooxygenase Inhibitors
  • Isoenzymes
  • Leukotrienes
  • Membrane Proteins
  • Prostaglandins
  • Cyclooxygenase 2
  • PTGS2 protein, human
  • Prostaglandin-Endoperoxide Synthases