Nephrotoxicity of selective COX-2 inhibitors.
We describe 2 male patients, a 49-year-old with psoriatic arthritis and impaired renal function and a 43-year-old renal transplant recipient, who both sustained a marked decline in glomerular filtration rate in conjunction with a selective inhibitor of cyclooxygenase-2 (COX-2), rofecoxib. In the second patient, acute renal failure necessitated hemodialysis. Both patients made an uneventful recovery. Our report lends further support to the assumption that COX-2 inhibitors, as a class, can be as nephrotoxic as their nonselective predecessors. Therefore, COX-2 inhibitors should be used with caution in renal transplant recipients and in patients with salt depletion and renal insufficiency.
Woywodt
A
A
Department of Medicine, University of Hannover School of Medicine, Germany. Woywodt.Alexander@MH-Hannover.de
Schwarz
A
A
Mengel
M
M
Haller
H
H
Zeidler
H
H
Köhler
L
L
D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000628:therapy; D000328:Adult; D015535:Arthritis, Psoriatic / Q000175:diagnosis / Q000188:drug therapy*; D016861:Cyclooxygenase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D007668:Kidney / Q000187:drug effects*; D007677:Kidney Function Tests; D016030:Kidney Transplantation; D007783:Lactones / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000175:diagnosis / Q000188:drug therapy*; D006435:Renal Dialysis / Q000379:methods; D018570:Risk Assessment; D013450:Sulfones
D016861:Cyclooxygenase Inhibitors; D007783:Lactones; D013450:Sulfones; C116926:rofecoxib