COX-2 selective inhibitors: analysis of the renal effects.
COX-2 selective inhibitors provide analgesia and blunt inflammation while also sparing the gastrointestinal tract from classic NSAID toxicity. Therapeutic effects are thought to result from inhibition of the inflammatory COX-2 isoform. Organ sparing is considered the result of preservation of homeostatic COX-1 enzyme function. Similar roles of the COX isoforms in the kidney would reduce NSAID-associated nephrotoxicity. However, human kidney tissue expresses COX-2 enzyme, suggesting a role for this isoform in maintenance of physiological renal processes. Available clinical data on the renal effects of COX-2 selective inhibitors in humans also demonstrate nephrotoxic potential.
Perazella
Mark A
MA
Acute Dialysis Services, Section of Nephrology, Department of Medicine, Yale University School of Medicine, LMP 2071, 333 Cedar Street, New Haven, CT 06520-8029, USA. mark.perazella@yale.edu
D058186:Acute Kidney Injury / Q000139:chemically induced / Q000378:metabolism / Q000503:physiopathology; D000818:Animals; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects / Q000627:therapeutic use*; D016861:Cyclooxygenase Inhibitors / Q000009:adverse effects / Q000494:pharmacology*; D006801:Humans; D007668:Kidney / Q000187:drug effects / Q000378:metabolism / Q000502:physiology; D011453:Prostaglandins / Q000096:biosynthesis / Q000378:metabolism / Q000502:physiology
D000894:Anti-Inflammatory Agents, Non-Steroidal; D016861:Cyclooxygenase Inhibitors; D011453:Prostaglandins