Are cyclooxygenase-2-selective inhibitors safe for the kidneys?

Olivier Phan, Pascal Meier and Michel Burnier

Joint Bone Spine

2003, Vol 7, issue 4, pages 237-241.

An editorial in Joint Bone Spine has questioned the safety to the kidneys of the new generation of anti-inflammatory medications. The latest non-steroidal anti-inflammatory drugs (NSAIDs) are known as COX 2 inhibitors and their use has been advocated on the basis that they cause fewer side effects to the stomach and kidneys. Although there is evidence that COX-2 inhibitors reduce gastro-intestinal side effects, there is no such proof that these drugs are totally safe for the kidneys.

As with all medications, NSAIDs can have toxic effects on the kidneys. These effects can cause acute kidney failure, water retention, inflammation of the kidney or increased blood pressure. Usually, this is because they have the effect of decreasing blood flow to the kidney and filtration within it. Minor problems can be resolved by simply discontinuing the medication.

Although these conditions can affect anyone, certain people are more susceptible; older people, those with pre-existing kidney problems, diabetics, and those with cardiac problems. Phan et al conclude that COX 2 inhibitors have a similar degree of kidney toxicity to other NSAIDs and advocate physicians identifying high risk patients as the most effective way to prevent side effects. They also advocate using the lowest possible dosage for the shortest possible time.

Phan et al list the risk factors for renal toxicity of NSAIDs:

• Dimished effective arterial volume
• Pre-existing kidney failure
• Congestive heart failure
• Liver cirrhosis
• Nephrotic syndrome
• Volume depletion with dehydration
• Sepsis, anaeathesia
• Diuretics or laxatives
• Renin- angiotensin system inhibitors
• Advanced age
• Chronic kidney failure
• Diabetes
• Medications: eg cyclosporine, tacrolimus
  

Go to the journal >

• Home
• Research
• Research Reviews

© Copyright PhysioRoom.com 2001-2009. All rights reserved. Sitemap.

IMPORTANT SAFETY NOTICE
The articles on this web site are provided for general information only and should not be used as a basis for diagnosis or treatment. All exercises and information featured on this web site should only be practised under the supervision of a qualified healthcare professional.

We accept the following payment methods

PhysioRoom.com Limited, Unit 1 & 2 Dawson Court, Billington Road, Burnley, Lancashire BB11 5UB, England

Sports Injury & Physiotherapy Search Marketing by Epiphany.