Non-steroidal anti-inflammatory drugs and renal function

Area of Science:

• Nephrology
• Pharmacology
• Internal Medicine

Background:

• Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used for pain and inflammation.
• NSAID use is linked to various renal effects, impacting fluid and electrolyte balance.
• Adverse renal effects range from mild, transient issues to severe conditions like renal insufficiency, interstitial nephritis, and papillary necrosis.

Purpose of the Study:

• To review the renal effects of NSAIDs.
• To highlight the clinical significance of NSAID-induced kidney impairment in at-risk patients.
• To discuss the potential role of prostaglandin analogues in mitigating NSAID nephrotoxicity.

Main Methods:

• Literature review of NSAID-induced renal effects.
• Analysis of reported cases of drug-induced renal failure.
• Discussion of the mechanisms underlying NSAID nephrotoxicity.

Main Results:

• NSAIDs can cause reversible renal insufficiency, interstitial nephritis, and papillary necrosis.
• NSAID-induced acute renal failure accounts for a significant percentage of drug-induced renal failures.
• Haemodynamic renal failure from NSAIDs is typically reversible, whereas interstitial nephritis and papillary necrosis are often irreversible.

Conclusions:

• NSAID-related kidney function impairment is largely attributed to prostaglandin synthesis inhibition.
• Prostaglandin E1 (PGE1) analogue use is a potential strategy to prevent NSAID renal adverse effects in high-risk individuals.
• Further research is warranted to evaluate the efficacy of PGE1 analogues in preventing NSAID nephrotoxicity.