nonsteroidal anti-inflammatory drugs and the kidney非甾体类抗炎药物和肾脏.pdfVIP

Pharmaceuticals 2010, 3, 2291-2321; doi:10.3390/ph3072291 OPEN ACCESS pharmaceuticals ISSN 1424-8247 /journal/pharmaceuticals Review Nonsteroidal Anti-Inflammatory Drugs and the Kidney Walter H. Hörl Division of Nephrology and Dialysis, Department of Medicine III, Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria; E-Mail: walter.hoerl@meduniwien.ac.at; Tel.: +43-1-40400 4390; Fax: +43-1-40400-4392 Received: 30 June 2010; in revised form: 16 July 2010 / Accepted: 20 July 2010 / Published: 21 July 2010 Abstract: Non-steroidal anti-inflammatory drugs (NSAIDs) inhibit the isoenzymes COX-1 and COX-2 of cyclooxygenase (COX). Renal side effects (e.g., kidney function, fluid and urinary electrolyte excretion) vary with the extent of COX-2-COX-1 selectivity and the administered dose of these compounds. While young healthy subjects will rarely experience adverse renal effects with the use of NSAIDs, elderly patients and those with co-morbibity (e.g., congestive heart failure, liver cirrhosis or chronic kidney disease) and drug combinations (e.g., renin-angiotensin blockers, diuretics plus NSAIDs) may develop acute renal failure. This review summarizes our present knowledge how traditional NSAIDs and selective COX-2 inhibitors may affect the kidney under various experimental and clinical conditions, and how these drugs may influence renal inflammation, water transport, sodium and potassium balance and how renal dys