The effect of nonsteroidal antiinflammatory drugs on electrolyte homeostasis and blood pressure in young and elderly persons with and without renal insufficiency.

Abstract The study objective was to determine the acute and long-term effects ofnonsteroidal antiinflammatory drugs (NSAIDs) on the excretion of sodium and potassium, blood pressure, and body weight in young and elderly persons without renal insufficiency, and in elderly persons with moderate renal insufficiency. We conducted a randomized, open-label, three-way, crossover study in which subjects were administered 800, mg ibuprofen three times daily, 20 mg piroxicam daily, and 200 mg sulindac twice daily. Measurements included clearance and balance studies of the excretion of sodium and potassium during a 24- hour period, sitting systolic and diastolic blood pressures, and body weight measurements. Ibuprofen, piroxicam, and sulindac reduced excretion of sodium and potassium. Maximum decrements in the fractional excretion of sodium and potassium were significant for all NSAIDs in each group (P

[1]  S. Anderson,et al.  Nephron site of effect of nonsteroidal anti-inflammatory drugs on solute excretion in humans. , 1983, The American journal of physiology.

[2]  D. Klassen,et al.  Renal effects of ibuprofen, piroxicam, and sulindac in patients with asymptomatic renal failure. A prospective, randomized, crossover comparison. , 1990, Annals of internal medicine.

[3]  K. Berg,et al.  Acute renal effects of sulindac and indomethacin in chronic renal failure , 1985, Clinical pharmacology and therapeutics.

[4]  N. Fineberg,et al.  Effects of age on renal sodium homeostasis and its relevance to sodium sensitivity. , 1987, The American journal of medicine.

[5]  R. Wallace,et al.  Nonsteroidal anti-inflammatory drugs and blood pressure in an elderly population. , 1993, Journal of gerontology.

[6]  R. O. Day,et al.  The Problems and Pitfalls of NSAID Therapy in the Elderly (Part I) , 1991, Drugs & aging.

[7]  M. Murray,et al.  Nonsteroidal anti-inflammatory drugs. , 1990, Clinics in geriatric medicine.

[8]  K. Kokko,et al.  Inhibition of apical Na+ channels in rabbit cortical collecting tubules by basolateral prostaglandin E2 is modulated by protein kinase C. , 1992, The Journal of clinical investigation.

[9]  D. Brater,et al.  Effect of indomethacin on salt and water homeostasis , 1979, Clinical pharmacology and therapeutics.

[10]  M. Dunn,et al.  Renal effects of drugs that inhibit prostaglandin synthesis. , 1980, Kidney international.

[11]  G. Sturfelt,et al.  Effects of sulindac and naproxen on prostaglandin excretion in patients with impaired renal function and rheumatoid arthritis. , 1990, The American journal of medicine.

[12]  R. Ardaillou,et al.  Prostaglandins and other arachidonic acid metabolites in the kidney. , 1986, Kidney international.

[13]  D M Clive,et al.  Renal syndromes associated with nonsteroidal antiinflammatory drugs. , 1984, The New England journal of medicine.

[14]  S. Garella,et al.  Renal Effects of Prostaglandins and Clinical Adverse Effects of Nonsteroidal Anti‐Inflammatory Agents , 1984, Medicine.

[15]  T. A. Anderson,et al.  The effect of dietary sodium chloride on blood pressure, body fluids, electrolytes, renal function, and serum lipids of normotensive man. , 1976, The Journal of laboratory and clinical medicine.

[16]  B. Brenner,et al.  Importance of efferent arteriolar vascular tone in regulation of proximal tubule fluid reabsorption and glomerulotubular balance in the rat. , 1980, The Journal of clinical investigation.

[17]  R J Glynn,et al.  Initiation of antihypertensive treatment during nonsteroidal anti-inflammatory drug therapy. , 1994, JAMA.

[18]  M. Lifschitz,et al.  Effect of prostaglandins on renal salt and water excretion. , 1986, The American journal of medicine.

[19]  R. DeFronzo,et al.  Hyperkalemia and hyporeninemic hypoaldosteronism. , 1980, Kidney international.

[20]  E. Anggard,et al.  Formation and metabolism of prostaglandins in the kidney. , 1981, Kidney international.

[21]  H. Jacobson,et al.  Prostaglandin E2 inhibits sodium transport in rabbit cortical collecting duct by increasing intracellular calcium. , 1991, The Journal of clinical investigation.

[22]  M. Murray,et al.  Acute and Chronic Effects of Nonsteroidal Antiinflammatory Drugs on Glomerular Filtration Rate in Elderly Patients , 1995, The American journal of the medical sciences.

[23]  C. Patrono,et al.  Effects of sulindac and ibuprofen in patients with chronic glomerular disease. Evidence for the dependence of renal function on prostacyclin. , 1984, The New England journal of medicine.

[24]  D. Brater.  Clinical aspects of renal prostaglandins and NSAID therapy. , 1988, Seminars in arthritis and rheumatism.

[25]  L. Arisz,et al.  The effect of indomethacin on kidney function and plasma renin activity in man. , 1976, Nephron.

[26]  M J Dunn,et al.  Prostaglandins and the kidney. , 1977, The American journal of physiology.

[27]  Y. Friedlander,et al.  Non-steroidal anti-inflammatory drugs and hypertension in the elderly: a community-based cross-sectional study. , 1993, British journal of clinical pharmacology.

[28]  C. Swainson,et al.  Acute and chronic effects of sulindac on renal function in chronic renal disease , 1985, Clinical pharmacology and therapeutics.

[29]  W. Hsueh,et al.  Effects of sulindac and ibuprofen in patients with cirrhosis and ascites. An explanation for the renal-sparing effect of sulindac. , 1986, Gastroenterology.

[30]  R. Toto,et al.  Effects of acute and chronic dosing of NSAIDs in patients with renal insufficiency. , 1986, Kidney international.