Effect of Naproxen on Renal Haemodynamics in Elderly Patients with Arthritis

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Abstract
The effects of naproxen on renal haemodynamics were observed in ten elderly arthritic patients who were otherwise healthy and without clinical evidence of renal disease. Glomerular filtration rate (GFR,51Cr-EDTA clearance) and effective renal plasma flow (ERPF, 125I-iodohippurate clearance) were measured after 2 weeks' treatment with naproxen 500 mg twice daily and again after 2 weeks off the drug, in random order. Baseline values for GFR and ERPF were within normal limits (mean 72 ml/min/1.73 m2, 110° predicted and 326 ml/min/1.73 m2, 111° predicted, respectively). On naproxen, ERPF and renal blood flow decreased by 10° and 9°, respectively (−32 ml/min/1.73 m2; p=0.05 and −49 ml/min/1.73 m2; p<0.01). These events produced no untoward clinical effects. Nevertheless, this response might impair the kidney's ability to preserve GFR if a further stress were to supervene. Consequently, temporary withdrawal of non-steroidal anti-inflammatory drugs from elderly patients should be considered in response to intercurrent illness or drug therapy likely to compromise renal blood flow.