Avtor/Urednik		Ravnikar, Andreja; Lindič, Jelka
Naslov		Nesteroidni antirevmatiki (NSAR) in ledvice
Prevedeni naslov		Non-steroidal antiinflamatory drugs (NSAIDs) and the kidney
Tip		članek
Vir		Med Razgl
Vol. in št.		Letnik 46, št. 4
Leto izdaje		2007
Obseg		str. 337-45
Jezik		slo
Abstrakt		Non-steroidal antiinflammatory drugs (NSAIDs) are among the most widely utilized therapeutic agents today. The main mechanism of their action is via inhibition of cyclooxygenase, the enzyme involved in prostaglandin synthesis. Prostaglandins play a crucial role in the renal circulation when systemic circulation is destabilized or when the blood volume and tive arterial blood volume are compromised. They enable vasodilatation of the renal circulation, renin secretion, and sodium and water excretion. There are two isoforms of cyclooxygenase (COX) (COX-1 or the "constitutive" isoform and COX-2 or the »inducible« isoform). The inhibition of COX-2, which is normally expressed in activated macrophages and induced by proinflammatory substances, accounts for antiinflammatory, analgesic and antipyretic effects whereas COX-1 suppression causes most side effects, for example gastrointestinal bleeding and ulceration, and platelet dysfunction. It was assumed that selective inhibition of COX-2 would diminish the wide range of toxic organ effects of nonselective NSAIDs. In the kidney, constitutive expression has been demonstrated for both isoforms. Renal toxicity is therefore similar in nonselective and selective COX-2 inhibitors. Moreover, a number of analyses have suggested that prolonged exposure to selective COX-2 inhibitors increases the risk of cardiovascular disease. Renal toxicity associated with the use of NSAIDs can be classified in several distinct clinical syndromes: acute hemodynamic renal failure, acute tubulointerstitial nephritis with nephrotic syndrome and chronic kidney disease. They differ in the time of drug use that is required for its development, pathogenesis and treatment.
Deskriptorji		DICLOFENAC NEPHRITIS, INTERSTITIAL KIDNEY FAILURE NEPHROTIC SYNDROME