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Identification of Novel CK2 Kinase Substrates Using a Versatile Biochemical Approach
Published on: February 21, 2019
Cyclooxygenase-2 selective inhibitors and the kidney
M D Breyer1, C Hao, Z Qi
1Division of Nephrology and Department of Medicine, Veterans Administration Medical Center and Vanderbilt University, Nashville, Tennessee 37232, USA. matthew.breyer@mcmail.vanderbilt.edu
Current Opinion in Critical Care
|January 24, 2002
Summary
Non-steroidal anti-inflammatory drugs (NSAIDs) block cyclooxygenases (COX), potentially causing kidney dysfunction, especially during physiological stress. Selective COX2 inhibitors also pose renal risks, necessitating caution in vulnerable patients.
Area of Science:
- Pharmacology
- Nephrology
- Biochemistry
Background:
- Cyclooxygenases (COX) metabolize arachidonate to prostaglandins, mediating inflammation and pain.
- Non-steroidal anti-inflammatory drugs (NSAIDs) inhibit COX enzymes, providing therapeutic effects but carrying risks.
- Renal function can become prostaglandin-dependent during physiological stress.
Purpose of the Study:
- To review the renal effects of NSAIDs, including selective COX2 inhibitors.
- To highlight the risks associated with NSAID use in patients under physiological stress.
- To emphasize the importance of caution when prescribing COX inhibitors.
Main Methods:
- Literature review of studies on COX enzymes, NSAIDs, and renal function.
- Analysis of data regarding the renal effects of selective COX2 inhibitors.
- Examination of the role of prostaglandins in renal physiology during stress.
Main Results:
- Both COX1 and COX2 are expressed in the kidney and inhibited by conventional NSAIDs.
- NSAID use is linked to gastrointestinal bleeding and renal dysfunction, including sodium retention, edema, hypertension, hyperkalemia, and papillary necrosis.
- Selective COX2 inhibitors, while sparing the gastrointestinal tract, exhibit similar renal adverse effects as non-selective NSAIDs.
Conclusions:
- NSAIDs, including selective COX2 inhibitors, can impair renal function, particularly in stressed patients.
- Prostaglandins play a crucial role in maintaining renal function under physiological stress.
- Prescribers should exercise caution when administering COX inhibitors to patients susceptible to renal dysfunction.
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