Video Experimental Relacionado

Updated: Aug 15, 2026

5/6th Nephrectomy in Combination with High Salt Diet and Nitric Oxide Synthase Inhibition to Induce Chronic Kidney Disease in the Lewis Rat

5/6th Nephrectomy in Combination with High Salt Diet and Nitric Oxide Synthase Inhibition to Induce Chronic Kidney Disease in the Lewis Rat

Published on: July 3, 2013

Azotemia asociada a fármacos antiinflamatorios no esteroideos en el grupo muy antiguo

J H Gurwitz¹, J Avorn, D Ross-Degnan

¹Program for the Analysis of Clinical Strategies, Beth Israel Hospital and Harvard Medical School, Boston, Mass.

|July 25, 1990

Resumen

El uso a corto plazo de fármacos antiinflamatorios no esteroideos (AINE) en personas muy ancianas puede causar una lesión renal reversible, lo que lleva a niveles elevados de nitrógeno de urea. El uso simultáneo de diuréticos y dosis más altas de AINE aumentan este riesgo.

Área de la Ciencia:

Gerontología Gerontología.
Nefrología Nefrología.
Farmacología Farmacología.

Sus antecedentes:

Las personas mayores son susceptibles a reacciones adversas a los medicamentos.
Los medicamentos antiinflamatorios no esteroideos (AINE) se usan comúnmente para el control del dolor.

Objetivo del estudio:

Para investigar los efectos renales de la terapia a corto plazo con antiinflamatorios no esteroideos (AINE) en pacientes muy ancianos.
Para identificar los factores de riesgo para la lesión renal inducida por AINE en esta población.

Principales métodos:

Estudio prospectivo en el que participaron 114 pacientes ancianos (edad media de 87 años) en un centro de cuidados a largo plazo iniciando la terapia con AINE.
Los niveles séricos de urea nitrógeno, creatinina y potasio fueron monitoreados 5-7 días después de la iniciación de los AINE.
Se incluyó un grupo de comparación de 45 pacientes que no recibían AINE.
Se analizaron los factores de riesgo para aumentos significativos en el nitrógeno de urea sérica.

Principales resultados:

Se observó un aumento significativo en el nitrógeno de urea sérica (1.7 mmol / L) en el grupo de AINE, sin cambios en la creatinina o el potasio.
El 13% de los pacientes experimentaron un aumento de >50% en el nitrógeno de urea sérica, volviendo a la línea de base dentro de los 14 días posteriores a la interrupción del tratamiento.
La terapia diurética de bucle simultánea (OR, 2.2) y la dosis alta de AINE (OR, 2.0) fueron predictores significativos del aumento del nitrógeno de urea sérica.

Conclusiones:

La terapia de AINE a corto plazo puede inducir azotemia reversible en una proporción sustancial de pacientes muy ancianos.
El uso de diuréticos en bucle y la dosis alta de AINE son factores de riesgo clave para la lesión renal inducida por AINE en este grupo de edad.
El monitoreo cuidadoso y la consideración de los factores de riesgo son esenciales cuando se prescriben AINE a los ancianos.

Más Videos Relacionados

Induction of Nephrotic Syndrome in Mice by Retrobulbar Injection of Doxorubicin and Prevention of Volume Retention by Sustained Release Aprotinin

Induction of Nephrotic Syndrome in Mice by Retrobulbar Injection of Doxorubicin and Prevention of Volume Retention by Sustained Release Aprotinin

Published on: May 6, 2018

Dioscin Mediated IgA Nephropathy Alleviation by Inhibiting B Cell Activation In Vivo and Decreasing Galactose-Deficient IgA1 Production In Vitro

Dioscin Mediated IgA Nephropathy Alleviation by Inhibiting B Cell Activation In Vivo and Decreasing Galactose-Deficient IgA1 Production In Vitro

Published on: October 13, 2023

Videos de Conceptos Relacionados

Antihypertensive Drugs: Direct Renin Inhibitors

Antihypertensive Drugs: Direct Renin Inhibitors

The renin-angiotensin-aldosterone system (RAAS) is an intricate physiological pathway involving numerous enzymes and hormones, including renin, angiotensin-converting enzyme (ACE), angiotensin I and II, and aldosterone. Imbalances within this system increase the production of angiotensin II and aldosterone. Increased angiotensin II levels promote vasoconstriction and blood pressure elevation. Concurrently, higher aldosterone levels stimulate sodium and water reabsorption in the kidneys,...

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...

Drug Dosing: Geriatric Patients

Drug Dosing: Geriatric Patients

Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism

Geriatric patients show significant variation in how their bodies process medications, which can change how effective and safe treatments are. The liver is the primary organ where drug metabolism occurs, involving two main types of chemical reactions: phase I and II. Phase I metabolism is driven by the cytochrome P450 enzyme system, which includes key types such as CYP3A, CYP2D6, and CYP2C9. Research indicates that while aging doesn't notably alter the levels or activity of these enzymes, it...

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion

In geriatric patients, renal physiology undergoes significant changes, including diminished renal blood flow and a lower glomerular filtration rate (GFR), leading to alterations in medication clearance. Drugs such as aminoglycoside antibiotics, lithium, and digoxin, which rely on glomerular filtration for removal from the body, particularly impact pharmacokinetics. These drugs tend to have slower clearance rates in older adults, necessitating careful dosage considerations.Evaluation of renal...

Acute Kidney Injury IV: Diagnostic Studies and Prevention

Acute Kidney Injury IV: Diagnostic Studies and Prevention

Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...