title: Short-term administration of diclofenac sodium affects renal function after laparoscopic radical nephrectomy in elderly patients.
abstract: OBJECTIVE
  Non-steroidal anti-inflammatory drugs decrease the glomerular filtration rate. However, few studies have been conducted on renal function in patients treated with non-steroidal anti-inflammatory drugs during the first week after laparoscopic radical nephrectomy. The purpose of this study is to determine whether short-term administration of non-steroidal anti-inflammatory drugs during the first week after laparoscopic radical nephrectomy is a risk factor for impaired renal function.
  
  
  METHODS
  Renal carcinoma patients undergoing laparoscopic radical nephrectomy in Nagoya University Hospital from April 2004 to July 2010 were identified in a retrospective cohort study. The 164 patients were divided into non-non-steroidal anti-inflammatory drug-treated (n=50) and non-steroidal anti-inflammatory drug-treated (n=114) groups.
  
  
  RESULTS
  Elderly patients (>60 years old) in the non-steroidal anti-inflammatory drug-treated group showed a significant correlation between the residual renal function ratio and the total dose of diclofenac sodium (r=-0.277, P<0.05). There was no significant correlation between the residual renal function ratio and the total dose of loxoprofen sodium. The time to doubling of the serum creatinine level was significantly shorter in elderly patients treated with diclofenac sodium compared with that in patients treated with non-non-steroidal anti-inflammatory drugs (P=0.034). These results suggest that renal ischemia induced by short-term administration of diclofenac sodium impairs renal function in elderly patients after laparoscopic radical nephrectomy.
  
  
  CONCLUSIONS
  In the present study, we found the first evidence that short-term administration of diclofenac sodium is one risk factor for renal impairment after laparoscopic radical nephrectomy in elderly patients. To prevent renal impairment after laparoscopic radical nephrectomy in elderly patients, the use of loxoprofen sodium, which has a negligible effect on renal function compared with diclofenac sodium, is recommended.
authors.affiliation: Division of Clinical Sciences and Neuropsychopharmacology, Meijo University Faculty of Pharmacy, 150 Yagotoyama, Tempaku, Nagoya 468-8503, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Mizuno
authors.forename: Kazuma
authors.initials: K
authors.lastname: Ito
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Miyagawa
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Ishikawa
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Suzuki
authors.forename: Masashi
authors.initials: M
authors.lastname: Mizuno
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Ito
authors.forename: Yasuhito
authors.initials: Y
authors.lastname: Funahashi
authors.forename: Ryohei
authors.initials: R
authors.lastname: Hattori
authors.forename: Momokazu
authors.initials: M
authors.lastname: Gotoh
authors.forename: Kiyofumi
authors.initials: K
authors.lastname: Yamada
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Noda
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D004008:Diclofenac / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007668:Kidney / Q000187:drug effects* / Q000503:physiopathology / Q000601:surgery*; D007680:Kidney Neoplasms / Q000503:physiopathology / Q000601:surgery; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D010666:Phenylpropionates / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D010666:Phenylpropionates; D004008:Diclofenac; C040656:loxoprofen