Antiinflammatory Drugs and the Kidney

Abstract

Abstract Nonsteroidal antiinflammatory drugs (NSAIDs) are prescribed widely in clinical practice and are available without a prescription. NSAIDs, including the more selective inhibitors of cyclooxygenase 2 (coxibs), are potentially nephrotoxic and can have significant side effects, including salt and water retention, acute tubular necrosis, acute interstitial nephritis, proteinuria, hyperkalemia, and various degrees of renal damage evolving into chronic kidney disease. Although the potential for these side effects is relatively low, the widespread use of these drugs makes the incidence of complications frequent. An understanding of the mechanisms by which NSAIDs can affect kidney function and extracellular fluid volume status is important for critical care practitioners who will most certainly manage patients with varying exposure to NSAIDs.