Non-steroidal antiinflammatory drugs (NSAIDs) are among the most widely utilized thera\u00adpeutic agents today. The main mechanism of their action is via inhibition of cyclooxygenase, the enzyme involved in prostaglandin synthesis. Prostaglandins play a crucial role in the renal circulation when systemic circulation is destabilized or when the blood volume and effec\u00adtive arterial blood volume are compromised. They enable vasodilatation of the renal circulation, renin secretion, and sodium and water excretion. There are two isoforms of cyclooxygenase (COX) (COX-1 or the \u00bbconstitutive\u00ab isoform and COX-2 or the \u00bbinducible\u00ab isoform). The inhi\u00adbition of COX-2, which is normally expressed in activated macrophages and induced by proinflammatory substances, accounts for antiinflammatory, analgesic and antipyretic effects whereas COX-1 suppression causes most side effects, for example gastrointestinal bleed\u00ading and ulceration, and platelet dysfunction. It was assumed that selective inhibition of COX-2 would diminish the wide range of toxic organ effects of nonselective NSAIDs. In the kidney, constitutive expression has been demonstrated for both isoforms. Renal toxicity is therefore similar in nonselective and selective COX-2 inhibitors. Moreover, a number of analyses have\u00a0suggested that prolonged exposure to selective COX-2 inhibitors increases the risk of car\u00addiovascular disease. Renal toxicity associated with the use of NSAIDs can be classified in several distinct clinical syndromes: acute hemodynamic renal failure, acute tubulointerstitial nephri\u00adtis with nephrotic syndrome and chronic kidney disease. They differ in the time of drug use that is required for its development, pathogenesis and treatment<\/p>\n","protected":false},"excerpt":{"rendered":"
Non-steroidal antiinflammatory drugs (NSAIDs) are among the most widely utilized thera\u00adpeutic agents today. The main mechanism of their action is via inhibition of cyclooxygenase, the enzyme involved in prostaglandin synthesis. Prostaglandins play a crucial role in the renal circulation when systemic circulation is destabilized or when the blood volume and effec\u00adtive arterial blood volume are […]<\/p>\n","protected":false},"author":28,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":"","_links_to":"","_links_to_target":""},"categories":[377,426],"tags":[],"class_list":["post-5752","post","type-post","status-publish","format-standard","hentry","category-4-2007-archive","category-internal-medicine"],"acf":[],"yoast_head":"\n