NSAID-induced renal diseases

出自KMU Wiki

1. Acute renal failure
   1. Hemodynamic (common)
      1. NSAID inhibits vasodilatory prostaglandins → afferent arteriole vasoconstriction
      2. Pre-renal azotemia may result in acute renal failure due to acute tubular necrosis
   2. Acute interstitial nephritis

• • • Less common
    • Nephrotic syndrome
    • Mostly with propionic acid ~NSAIDs (fenoprofen, ibuprofen, naproxen), but also occurs in ampicillin, rifampicin, α-interferon
    • This is an exception to the rule that "most interstitial nephritis is associated with mild to moderate proteinuria"
    • Remission after stopping offending drugs

1. Papillary necrosis
2. Fluid & electrolyte disturbances
   1. Salt & water retention
   2. Edema
   3. Hyponatremia
   4. Hyperkalemia 
3. Nephroitc syndrome
   1. Minimal change dis.
   2. Membranous nephropathy
4. ESRD