Renal Effects of COX-2-Selective Inhibitors

@article{Brater2001RenalEO,
  title={Renal Effects of COX-2-Selective Inhibitors},
  author={Dr D. Craig Brater and Cynthia J Harris and Jan Stephen Redfern and Barry J. Gertz},
  journal={American Journal of Nephrology},
  year={2001},
  volume={21},
  pages={1 - 15}
}
Although nonsteroidal anti-inflammatory drugs (NSAIDs) effectively treat a variety of inflammatory diseases, these agents may cause deleterious effects on kidney function, especially with respect to solute homeostasis and maintenance of renal perfusion and glomerular filtration. NSAIDs act by reducing prostaglandin biosynthesis through inhibition of cyclooxygenase (COX) which exists as two isoforms (COX-1 and COX-2). NSAID-induced gastrointestinal toxicity is generally believed to occur through… 

Figures and Tables from this paper

Anti-inflammatory agents and renal function.
  • D. Brater
  • Medicine
    Seminars in arthritis and rheumatism
  • 2002
TLDR
Patients who are at risk for adverse renal events should be monitored with the same caution when receiving coxibs as when receiving treatment with nonselective NSAIDs.
COX-2 and the Kidney
  • R. Harris
  • Medicine, Biology
    Journal of cardiovascular pharmacology
  • 2006
TLDR
Caution should be taken when COX-2 inhibitors are prescribed, especially in high-risk patients (including elderly patients and patients with volume depletion).
RENAL TOXICITY OF THE SELECTIVE CYCLOOXYGENASE-2 INHIBITORS: CELECOXIB AND ROFECOXIB
TLDR
The conclusion was that the selective cyclooxygenase-2 inhibitors don’t have higher renal safety than other non-steroidal anti-inflammatory drugs and, like them, must be used either cautiously or not at all in patients with predisposing diseases.
COX-2 selective inhibitors: analysis of the renal effects
  • M. Perazella
  • Biology, Medicine
    Expert opinion on drug safety
  • 2002
TLDR
COX-2 selective inhibitors provide analgesia and blunt inflammation while also sparing the gastrointestinal tract from classic NSAID toxicity while also suggesting a role for this isoform in maintenance of physiological renal processes.
Nonsteroidal Anti-Inflammatory Drugs and the Kidney
  • W. Hörl
  • Medicine, Biology
    Pharmaceuticals
  • 2010
TLDR
This review summarizes the 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 dysfunction or hypertension may result.
Non-steroidal antiinflammatory drugs (NSAIDs) (ยาลดการอักเสบที่ไม่ใช่เสตียรอยด์)
TLDR
All COX-2 inhibitors have comparable efficacy to traditional NSAIDs but provide a slightly better gastrointestinal safety profile and carry some potential cardiovascular risks, particularly when taking at high doses for prolonged periods of time.
Immunohistochemical localisation of renal cyclooxygenase-1 expression in non-steroidal anti-inflammatory drug-treated mice.
  • M. Meskell, R. Ettarh
  • Medicine, Biology
    Experimental and toxicologic pathology : official journal of the Gesellschaft fur Toxikologische Pathologie
  • 2011
Novel mechanisms of nonsteroidal anti-inflammatory drug-induced renal toxicity
TLDR
The common involvement of UGT in the metabolism of arachidonic acid, eicosanoids and NSAIDs is discussed in the context of novel mechanisms of NSAID-induced nephrotoxicity.
Potential Cardiovascular Effects of COX-2 Selective Nonsteroidal Antiinflammatory Drugs
  • R. Fowles
  • Medicine, Biology
    Journal of pain & palliative care pharmacotherapy
  • 2003
The newly developed nonsteroidal antiinflammatory drugs (NSAIDs) that selectively inhibit cyclooxygenase-2 (COX-2), are effective against pain and inflammation and appear to have less
The Renal Effects of Traditional Nonsteroidal Anti-Inflammatory Agents Versus Cyclooxygenase-2 Inhibitors
TLDR
Because many older patients have conditions that place them in one of the “at-risk” categories, this population should be monitored closely for the development of renal adverse events from any NSAIDs, including COX-2-selective agents.
...
...

References

SHOWING 1-10 OF 87 REFERENCES
Effect of Cyclooxygenase-2 Inhibition on Renal Function in Elderly Persons Receiving a Low-Salt Diet
TLDR
To determine the effects of COX-2 inhibition on glomerular filtration rate and serum and urine electrolyte balance, rofecoxib was administered to elderly patients who were receiving a sodium-restricted diet, which enhanced renal dependence on prostaglandin production.
Renal safety and tolerability of celecoxib, a novel cyclooxygenase-2 inhibitor.
TLDR
It is concluded that celecoxib is well tolerated by patients who may be at risk for NSAID-induced renal toxicity, such as the elderly and those with hypertension or preexisting chronic heart disease, and there was no evidence of drug-drug interactions between cele Coxib and concomitant angiotensin-converting enzyme (ACE) inhibitors, beta-blockers, calcium channel blockers, or diuretics.
Effects of specific inhibition of cyclooxygenase-2 on sodium balance, hemodynamics, and vasoactive eicosanoids.
TLDR
The data suggest that acute sodium retention by nonsteroidal anti-inflammatory drugs in healthy elderly subjects is mediated by the inhibition of Cox-2, whereas depression of GFR is due to inhibition ofcox-1.
Adverse effects of nonsteroidal anti-inflammatory drugs on the gastrointestinal system.
  • E. Fosslien
  • Biology, Medicine
    Annals of clinical and laboratory science
  • 1998
TLDR
Surprisingly, COX-2 null mice are able to mount an inflammatory response, suffering however, from kidney dysfunction and a shortened life span.
Renal abnormalities and an altered inflammatory response in mice lacking cyclooxygenase II
TLDR
An animal model of COX-2 deficiency that was generated by gene targeting failed to alter inflammatory responses in several standard models, but striking mitigation of endotoxin-induced hepatocellular cytotoxicity was observed.
Interspecies Differences in Renal Localization of Cyclooxygenase Isoforms: Implications in Nonsteroidal Antiinflammatory Drug-Related Nephrotoxicity
TLDR
Significant interspecies differences exist in the presence and distribution of COX isoforms, which may help explain the difference in species susceptibility to NSAID-related renal toxicity.
Are selective COX-2 inhibitors nephrotoxic?
  • M. Perazella, J. Eras
  • Medicine, Biology
    American journal of kidney diseases : the official journal of the National Kidney Foundation
  • 2000
...
...