Effects of two nonsteroidal anti-inflammatory drugs, indomethacin and oxaprozin, on the kidney

Clin Pharmacol Ther. 1980 Nov;28(5):680-9. doi: 10.1038/clpt.1980.221.

Abstract

Nonsteroidal anti-inflammatory drugs (NSAIDs) have been found to cause sodium retention and to decrease glomerular filtration rate (GFR). We studied the effects of two such drugs, indomethacin and oxaprozin, a new propionic acid derivative, on renal function of awake, normal human subjects during sustained water diuresis. Although neither drug had a long-term effect on GFR or sodium clearance (CNa), indomethacin (six subjects) but not oxaprozin (seven subjects) transiently reduced GFR and CNa. Given over the short term, oxaprozin caused a reduction in GFR from 113.7 +/- 5.7 to 99.8 +/- 4.7 ml/min (p < 0.01) and CNa from 0.84 +/- 0.07 to 0.61 +/- 0.08 ml/min (p < 0.005). The results were much the same when an additional dose of indomethacin was given to subjects who had been receiving the drug for a week. Inference from clearance data at a time when urinary osmolality (Uosm) remained constant but urine flow per GFR (V/GFR) fell suggests that both drugs stimulated proximal tubular sodium and fluid resorption. Both suppressed renin and aldosterone levels comparably and reduced potassium excretion transiently, but only indomethacin caused a sustained change in serum potassium concentration; serum potassium rose from 4.32 +/- 0.10 to 4.56 +/- 0.11 mEq/l (p < 0.05) after 1 wk. These disparate findings suggest that prostaglandin synthesis inhibition may not be the sole mechanism of action of NSAIDs.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aldosterone / urine
  • Anti-Inflammatory Agents / pharmacology*
  • Diuresis / drug effects
  • Glomerular Filtration Rate / drug effects
  • Humans
  • Indomethacin / pharmacology*
  • Kidney / drug effects*
  • Kidney Concentrating Ability / drug effects
  • Male
  • Oxaprozin
  • Oxazoles / pharmacology*
  • Propionates / pharmacology*
  • Prostaglandins / physiology
  • Renin / blood
  • Sodium / metabolism

Substances

  • Anti-Inflammatory Agents
  • Oxazoles
  • Propionates
  • Prostaglandins
  • Aldosterone
  • Sodium
  • Renin
  • Oxaprozin
  • Indomethacin