Are selective COX-2 inhibitors nephrotoxic?
Nonsteroidal anti-inflammatory drugs are well-known culprits in the development of acute renal insufficiency in high-risk patients. The recent release of the selective cyclooxygenase-2 enzyme inhibitors for the treatment of inflammatory diseases and pain syndromes has been associated with a clear-cut decrease in adverse gastrointestinal effects. However, the nephrotoxic potential of these agents in patients with prostaglandin-dependent states and chronic renal impairment is unknown. Many clinicians commonly wonder if these agents can be safely prescribed to such high-risk patients. We present two cases of acute renal failure complicating the course of therapy with celecoxib in patients with chronic renal insufficiency.
Perazella
M A
MA
Department of Internal Medicine, Section of Nephrology, Yale University School of Medicine, New Haven, CT 06520, USA. mark.perazella@yale.edu
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D000208:Acute Disease; D000368:Aged; D000068579:Celecoxib; D051546:Cyclooxygenase 2; D052246:Cyclooxygenase 2 Inhibitors; D016861:Cyclooxygenase Inhibitors / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007527:Isoenzymes / Q000494:pharmacology*; D008297:Male; D008565:Membrane Proteins; D008875:Middle Aged; D010544:Peroxidases / Q000037:antagonists & inhibitors*; D011451:Prostaglandin-Endoperoxide Synthases / Q000494:pharmacology*; D011720:Pyrazoles; D051437:Renal Insufficiency / Q000139:chemically induced*; D013449:Sulfonamides / Q000009:adverse effects*
D052246:Cyclooxygenase 2 Inhibitors; D016861:Cyclooxygenase Inhibitors; D007527:Isoenzymes; D008565:Membrane Proteins; D011720:Pyrazoles; D013449:Sulfonamides; D010544:Peroxidases; D051546:Cyclooxygenase 2; C496540:PTGS2 protein, human; D011451:Prostaglandin-Endoperoxide Synthases; D000068579:Celecoxib