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Nephrologie. 2000;21(8):425-30.

[Selective inhibitors of type 2 cyclooxygenase: less renal effects than the classical non-steroidal anti-inflammatory agents].

[Article in French]

Author information

1
Division d'hypertension et de médecine vasculaire, Centre hospitalier universitaire vaudois, Lausanne.

Abstract

Prostaglandins play an important role in the regulation of renal hemodynamics and sodium excretion. Thus, the administration of non-steroidal anti-inflammatory drugs (NSAIDs) induces a renal vasoconstriction and sodium and potassium retention. In some high risk patients, this may lead to acute renal failure. The anti-inflammatory and renal effects of conventional NSAIDs are mediated by the non-selective inhibition of two cyclo-oxygenases, COX-1 and COX-2. Recently, highly selective COX-2 inhibitors have been developed such as celecoxib (Celebrex) and rofecoxib (Vioxx). These drugs were designed to preserve the analgesic and anti-inflammatory properties of NSAIDs while reducing their gastro-intestinal and renal side effects. Selective COX-2 inhibitors have indeed less gastro-intestinal side-effects. However, their renal profile is comparable to that of non-selective inhibitors as they induce a decrease in glomerular filtration rate and a sodium and potassium retention. Thus, despite the good gastro-intestinal safety profile of selective COX-2, one should be careful with the use of these agents in high risk patients as they may induce similar renal complications as non-selective NSAIDs.

PMID:
11213386
[Indexed for MEDLINE]
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