This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Should We Be Concerned?

M. Thomas Stillman, MD; Peter A. Schlesinger, MD

Arch Intern Med. 1990;150(2):268-270.

Abstract
• Various nephrotoxicity syndromes are seen with the use of nonsteroidal anti-inflammatory drugs (NSAIDs). The most common is reversible, hemodynamically mediated renal insufficiency. The role of prostaglandin inhibition by NSAIDs is discussed in the context of renal prostaglandin physiology. Potential differences among NSAIDs are reviewed. The "renal sparing" effect of sulindac may be attributable to the relative preservation of renal prostaglandin synthesis. Salsalate, although anti-inflammatory, demonstrates weak prostaglandin inhibition at therapeutic doses. A framework is developed for the clinical application of these considerations. Along a continuum of increasing risk factors for NSAID nephrotoxicity, or increasing NSAID dose, there likely exists a therapeutic window where differences among NSAIDs are most relevant.

(Arch Intern Med. 1990;150:268-270)

Author Affiliations
From the Rheumatology Division, Department of Medicine, Hennepin County Medical Center and the University of Minnesota Medical School, Minneapolis.

Footnotes
Accepted for publication July 24,1989.

Presented at the 52nd Annual Meeting of the American Rheumatism Association, Houston, Tex, May 25,1988.

Reprint requests to the Department of Medicine, Hennepin County Medical Center, 701 Park Ave S, Minneapolis, MN 55415 (Dr Stillman).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

A Meta-analysis of the Effects of Nonsteroidal Anti-inflammatory Drugs on Blood Pressure
Pope et al.
Arch Intern Med 1993;153:477-484.
ABSTRACT  

Cost-Conscious Prescribing of Nonsteroidal Anti-inflammatory Drugs for Adults With Arthritis: A Review and Suggestions
Greene and Winickoff
Arch Intern Med 1992;152:1995-2002.
ABSTRACT  

Tell Your Kidneys to Take a Powder
Mitchell
Arch Intern Med 1991;151:617-617.
ABSTRACT  

Nonsteroidal Anti-inflammatory Drug--Associated Azotemia in the Very Old
Gurwitz et al.
JAMA 1990;264:471-475.
ABSTRACT  

Adverse Effects of Nonsteroidal Anti-inflammatory Drugs on Renal Function
Murray and Brater
ANN INTERN MED 1990;112:559-560.
ABSTRACT