Nonsteroidal anti-inflammatory drugs (NSAID) may cause renal failure in some patients. NSAIDs decrease the synthesis of renal vasodilator prostaglandins with a decrease in renal blood flow. The presence of certain clinical factors associated with a stimulated renin-angiotensin system may result in an increased risk for developing renal dysfunction which is largely reversible.


Risk factors for renal failure associated with NSAID use:

(1) advanced age

(2) congestive heart failure (NYHA Class III and IV)

(3) ascites

(4) volume depletion

(5) diuretic therapy

(6) concomitant use of aspirin

(7) hypertension

(8) diabetes

(9) pre-existing renal insufficiency


Rarely an acute interstitial nephritis with proteinuria may be caused by NSAIDs.


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