Sulindac is not renal sparing in man

Area of Science:

• Nephrology
• Pharmacology

Background:

• Nonsteroidal anti-inflammatory drugs (NSAIDs) can affect kidney function.
• Cyclooxygenase (COX) inhibitors, like sulindac and indomethacin, are commonly used NSAIDs.

Purpose of the Study:

• To investigate the renal-sparing effects of sulindac compared to indomethacin.
• To assess the impact of these NSAIDs on renal prostaglandin synthesis and sodium balance.

Main Methods:

• A randomized controlled trial involving 15 women.
• Assessment of renal function via prostaglandin E2 excretion, sodium balance, plasma renin activity (PRA), and furosemide response.
• Evaluation of systemic effects through platelet aggregation, thromboxane B2 formation, and PGF2 alpha metabolite excretion.

Main Results:

• Both sulindac and indomethacin reduced urinary prostaglandin E2 excretion and led to positive sodium balance.
• Both drugs inhibited the increase in PRA and urinary PGE2 excretion in response to furosemide.
• Sulindac decreased furosemide-induced natriuresis, while indomethacin reduced the rise in inulin clearance.

Conclusions:

• Sulindac and indomethacin exhibit similar effects on the kidney, including reduced renal prostaglandin synthesis and altered sodium handling.
• Both NSAIDs interfere with the renal response to furosemide.
• Indomethacin demonstrated a stronger effect on platelet aggregation and thromboxane synthesis compared to sulindac.