ACUTE INTRINSIC RENAL-FAILURE INDUCED BY INDOMETHACIN - ROLE OF PROSTAGLANDIN SYNTHETASE INHIBITION

  • 1 January 1982
    • journal article
    • research article
    • Vol. 57  (5) , 289-296
Abstract
Nonsteroidal anti-inflammatory agents are often used to treat acute inflammatory arthritis because of their effectiveness and the infrequency of reported serious side effects. Two patients who had acute intrinsic renal failure triggered by indomethacin are described. Both patients were volume contracted and had other circulatory impairments. Azotemia was so severe as to require temporary hemodialysis in 1 patient. Intrinsic renal function began to recover within 5 days after discontinuation of indomethacin. At the time that recovery began, urinary prostaglandin [PG] excretion increased in both patients. Evidently renal PG production is an important compensatory response that helps to maintain renal function in the face of diminished renal blood flow. Apparently indomethacin, by interfering with this protective mechanism, can lead to acute intrinsic renal failure. Clinicians must be aware of this possible complication and use the nonsteroidal anti-inflammatory drugs with caution in patients who have compromised pre-renal status.