Abstract
Nonsteroidal antiinflammatory drugs (NSAID) are one of the most commonly used medications worldwide to inhibiting COX activity for the treatment of pain and inflammation. Their nephrotoxicity has been well documented. With the development and clinical implementation of new COX-2 inhibitors, the safety, including the effects on renal function and blood pressure, is attracting increasing attention. In the kidney, COX-2 is constitutively expressed and is highly regulated in response to alterations in intravascular volume. COX-2 metabolites have been implicated in mediation of renin release, regulation of sodium excretion and maintenance of renal blood flow. Similar to conventional NSAIDs, inhibition of COX-2 may cause edema and modest elevations in blood pressure in a minority of subjects. COX-2 inhibitors may also exacerbate preexisting hypertension or interfere with other antihypertensive drugs. Occasional acute renal failure has also been reported. Caution should be taken when COX-2 inhibitors are prescribed, especially in highrisk patients (including elderly and patients with volume depletion). Recently, agents with combined lipooxygenase/COX inhibition and agents that combine NSAIDs with a nitric oxide (NO) donor have been reported to reduce adverse renal effects.
Keywords: cox-2, cox-1, nsaid, hypertension, renin, sodium excretion, renal function, kidney
Current Pharmaceutical Design
Title: Renal Effects of Non-Steroidal Anti-Inflammatory Drugs and Selective Cyclooxygenase-2 Inhibitors
Volume: 11 Issue: 14
Author(s): H. F. Cheng and R. C. Harris
Affiliation:
Keywords: cox-2, cox-1, nsaid, hypertension, renin, sodium excretion, renal function, kidney
Abstract: Nonsteroidal antiinflammatory drugs (NSAID) are one of the most commonly used medications worldwide to inhibiting COX activity for the treatment of pain and inflammation. Their nephrotoxicity has been well documented. With the development and clinical implementation of new COX-2 inhibitors, the safety, including the effects on renal function and blood pressure, is attracting increasing attention. In the kidney, COX-2 is constitutively expressed and is highly regulated in response to alterations in intravascular volume. COX-2 metabolites have been implicated in mediation of renin release, regulation of sodium excretion and maintenance of renal blood flow. Similar to conventional NSAIDs, inhibition of COX-2 may cause edema and modest elevations in blood pressure in a minority of subjects. COX-2 inhibitors may also exacerbate preexisting hypertension or interfere with other antihypertensive drugs. Occasional acute renal failure has also been reported. Caution should be taken when COX-2 inhibitors are prescribed, especially in highrisk patients (including elderly and patients with volume depletion). Recently, agents with combined lipooxygenase/COX inhibition and agents that combine NSAIDs with a nitric oxide (NO) donor have been reported to reduce adverse renal effects.
Export Options
About this article
Cite this article as:
Cheng F. H. and Harris C. R., Renal Effects of Non-Steroidal Anti-Inflammatory Drugs and Selective Cyclooxygenase-2 Inhibitors, Current Pharmaceutical Design 2005; 11 (14) . https://dx.doi.org/10.2174/1381612053764922
DOI https://dx.doi.org/10.2174/1381612053764922 |
Print ISSN 1381-6128 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4286 |
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Physical Exercise and ACE2-Angiotensin-(1-7)-Mas Receptor Axis of the Renin Angiotensin System
Protein & Peptide Letters Pro-Inflammatory Gene Variants in Myocardial Infarction and Longevity: Implications for Pharmacogenomics
Current Pharmaceutical Design The No-Reflow Phenomenon in the Coronary Circulation
Cardiovascular & Hematological Agents in Medicinal Chemistry Tumor Necrosis Factor: Renaissance as a Cancer Therapeutic?
Current Cancer Drug Targets Lipid Nanoparticles for the Delivery of Active Natural Medicines
Current Pharmaceutical Design Inhibitors of Vascular Endothelial Growth Factor in Cancer
Cardiovascular & Hematological Agents in Medicinal Chemistry Advanced Nebulizer Designs Employing Vibrating Mesh/Aperture Plate Technologies for Aerosol Generation
Current Drug Delivery Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin Norepinephrine Reuptake Inhibitors (SNRIs) During Pregnancy and the Risk for Autism spectrum disorder (ASD) and Attention deficit hyperactivity disorder (ADHD) in the Offspring: A True Effect or a Bias? A Systematic Review & Meta-Analysis
Current Neuropharmacology Neuromuscular Disorders in Left Ventricular Hypertrabeculation/Noncompaction
Current Pharmaceutical Design Tissue Transglutaminase Expression During Neural Differentiation of Human Mesenchymal Stem Cells
CNS & Neurological Disorders - Drug Targets Early, Intensive and Long-term Statin Therapy in Acute Coronary Syndrome: Focus on Anti-inflammatory Mechanisms
Vascular Disease Prevention (Discontinued) Ethnicity and Drug Therapy for Hypertension
Current Pharmaceutical Design Renoprotective Effects of SGLT2 Inhibitors: Beyond Glucose Reabsorption Inhibition
Current Vascular Pharmacology Adaptive Filtering of the Arterial Wall: Frequency Response and Dynamical Parameters: Clinical Evaluation
Current Hypertension Reviews The Important New Drug Target in Cardiovascular Medicine – the Vascular Glycocalyx
Cardiovascular & Hematological Disorders-Drug Targets Age Related Macular Degeneration and Visual Disability
Current Drug Targets Nutraceuticals and their Novel Drug Delivery System: A Boon to Human Health
Current Nutrition & Food Science Cloning, Soluble Expression, and Production of Recombinant Antihypertensive Peptide Multimer (AHPM-2) in Escherichia coli for Bioactivity Identification
Protein & Peptide Letters Vascular Dysfunction in the Brain; Implications for Heavy Metal Exposures
Current Hypertension Reviews Obesity, Metabolic Syndrome and the Risk of Microvascular Complications in Patients with Diabetes mellitus
Current Pharmaceutical Design