Renal function nonsteroidal anti-inflammatory drug

Nonsteroidal anti-inflammatory drugs, colchicine, or corticosteroids are used for acute attacks. Selection depends on several patient factors, especially renal function. 

Diabetes is a major risk factor for deterioration in renal function after angiography (2,7,13). Other factors variably associated with increased rates of CIN include age over 75 years, anemia, female gender, periprocedural volume depletion, heart failure, cirrhosis, hypertension, proteinuria, concomitant use of nonsteroidal anti-inflammatory drugs, and intra-arteriai injection (2,4,5,7,10,13,14,19,43,44). In the setting of acute myocardial infarction or PCI, hypotension or use of an intra-aortic balloon pump has been associated with a higher rate of acute renal failure after exposure to a contrast medium (13,50). Finally, high doses of CM also increase the likelihood of renal dysfunction (51). 

Dunn Ml, Simonson M, Davidson EW, Scharschmidt LA, Sedor JR. Nonsteroidal anti-inflammatory drugs and renal function. J Chn Pharmacol 1988 28(6) 524-9. 

Murray MD, Brater DC. Adverse effects of nonsteroidal anti-inflammatory drugs on renal function. Ann Intern Med 1990 112(8) 559-60. 

De long PE, Statius van Eps LW. Sickle cell nephropathy new insights into its pathophysiology. Kidney Int 1985 27 711-719. Allen M, Lawson L, Eckman IR, Delaney V, Bourke E. Effects of nonsteroidal anti-inflammatory drugs on renal function in sickle cell anemia. Kidney Int 1988 34 500-506. 

SturmerT, Erb A, Keller F et al. Determinants of impaired renal function with use of nonsteroidal anti-inflammatory drugs the importance of half-life and other medications. American Journal of Medicine 2001 111 521-527. 

Altman RD, Perez GO, SfakianakisGN. Interaction ofcyclosporine Aand nonsteroidal anti-inflammatory drugs on renal function in patients with rheumatoid arthritis. Am J Med 1992 93 396-402. 

Nonsteroidal anti-inflammatory drugs (NSAIDs Group toxicity decreases renal function and platelet aggregati and stroke 3n may cause nephrotic syndrome, interstitial nephritis, hyperkalemia, sodium retention carries increased risk of CVD, Ml, ... 

The role of concomitant medication is not clear due to the lack of good clinical studies [9]. It is recommended to stop nonsteroidal anti-inflammatory drugs, metformin for the risk of lactic acidosis with decreasing renal function, and diuretics. Usually, diuretics used for long-term treatment of hypertension and inhibitors of the renin-angiotensin system should not be discontinued. 

The exact mechanism of the pentamidine-induced hyperkalemia has not yet been defined. Many different mechanisms can impair the renal handling of potassium and thus favor hyperkalemia in patients with AIDS. These include decreased renal function secondary to volume depletion, presence of under-lying renal disease, including tubular dysfunction with the possibility of hyporeninemic hypoaldos-teronism, hypoadrenalism, and the administration of drugs with potential for impairing renal potassium excretion (nonsteroidal anti-inflammatory agents, ACE inhibitors, potassium-sparing diuretics. 

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