Abstract
The recent release of the selective cyclooxygenase-2 (COX-2) enzyme inhibitors for the treatment of various inflammatory disorders and pain syndromes has been associated with a clear-cut decrease in adverse gastrointestinal effects. The nephrotoxic effect of selective COX-2 inhibitors has not yet been firmly established. We report a case of reversible acute renal failure due to rofecoxib treatment in an elderly patient with several risk factors associated with traditional nonselective nonsteroidal anti-inflammatory drug (NSAID)-related nephrotoxicity. It is prudent to approach therapy with selective COX-2 inhibitors cautiously and in a fashion similar to traditional NSAID therapy for patients with risk factors that induce prostaglandin-dependent renal function.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Brater DC. Effects of nonsteroidal anti-inflammatory drugs on renal function: focus on cyclooxygenase-2-selective inhibition. Am J Med 1999; 107(6A): 65S–70S.
Fitzgerald GA, Patrono C. The coxibs, selective inhibitors of cyslooxygenase-2. N Engl J Med 2001; 345: 433–442.
Chiolero A, Wurzner G, Burnier M. Selective inhibitors of type 2 cyclooxygenase: less renal effects than the classical non-steroidal anti-inflammatory agents. Nephrologie 2000; 21: 425–430.
Perazella MA, Eras J. Are selective COX-2 inhibitors nephrotoxic? Am J Kidney Dis 2000; 35: 937–940.
Komhoff M, Grone H-G, Klein T et al. Localization of cyclooxygenase-1 and-2 in adult and fetal human kidney: implication for renal function. Am J Physiol (Renal Physiol) 1997; 272: F480–F468.
Nantel F, Meadows E, Denis D et al. Immunolocalization of cyclooxygenase-2 in the macula densa of human elderly. FEBS Lett 1999; 457: 475–477.
Ferguson S, Hebert RL, Laneuville O. NS-398 upregulates constitutive cyclooxygenase-2 expression in the M-1 cortical collecting duct cell line. J Am Soc Nephrol 1999; 10: 2261–2271.
Ferreri NR, Shao-Jian A, McGiff J. Cyclooxygenase-2 expression and function in the medullary thick ascending limb. Am J Physiol (Renal Physiol) 1999; 277: F360–F368.
Abassi Z, Brodsky S, Gealekman O et al. Intrarenal expression and distribution of cyclooxygenase isoforms in rats with experimental heart failure. Am J Physiol 2001; 280: F43–F45.
Turull A, Piera C, Queralt J. Acute effects of the antiinflammatory cyclooxygenase-2 selective inhibitor, flosulide, on renal plasma flow and glomerular filtration rate in rats. Inflammation 2001; 25: 119–128.
Rossat J, Maillard M, Nussberger J et al. Renal effects of selective cyclooxygenase-2 inhibition in normotensive saltdepleted subjects. Clin Pharmacol Ther 1999; 66: 76–84.
Catella-Lawson F, McAdam B, Morrison BW et al. Effects of specific inhibition of cyclooxygenase-2 on sodium balance, hemodynamics and vasoactive eicosanoids. J Pharmacol Exp Ther 1999; 289: 725–741.
Swan SK, Lasseter KC, Ryan CF et al. Effect of cyclooxygenase inhibition on renal function in elderly persons receiving a low-salt diet. A randomized, controlled trial. Ann Intern Med 2000; 133: 1–9.
Whelton A, Schulman G, Wallemark C et al. Effects of celecoxib and naproxen on renal function in the elderly. Arch Intern Med 2000; 160: 1465–1470.
Braden GL, O'sheaM, Mulhern J, Germain MJ. COX-2 inhibitor acute renal failure: association with hyperkalemia and type IV renal tubular acidosis. J Am Soc Nephrol 2000; 11: 126A.
Stafford C, Bestoso JT. Celecoxib-induced acute renal failure. J Am Soc Nephrol 2000; 11: 134A.
Wolf G, Berth J, Stahl RA. Acute renal failure associated with rofecoxib. Ann Intern Med 2000; 133: 394.
Ofran Y, Bursztyn M, Ackerman Z. Rofecoxib-induced renal dysfunction in a patient with compensated cirrhosis and renal failure. Am J Gastroenterol 2001; 96: 1941.
Perazella MA, Tray K. Selective cyclooxygenase-2 inhibitors: a pattern of nephrotoxicity similar to traditional nonsteroidal anti-inflammatory drugs. Am J Med 2001; 111: 64–67.
Rocha JL, Fernadez-Alonso J. Acute tubulointerstitial nephritis associated with the selective COX-2 enzyme inhibitor, rofecoxib. Lancet 2001; 357: 1946–1947.
Whelton A, Maurath CJ, Verburg KM, Geis GS. Renal injury and tolerability of celecoxib, a novel cyclooxygenase-2 inhibitor. Am J Ther 2000; 7: 159–175.
Whelton A. Renal aspects of treatment with conventional nonsteroidal anti-inflammatory drugs versus cyclooxygenase-2 specific inhibitors. Am J Med 2001; 110(suppl1): 33–42.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Papaioannides, D., Bouropoulos, C., Sinapides, D. et al. Acute renal dysfunction associated with selective COX-2 inhibitor therapy. Int Urol Nephrol 33, 609–611 (2001). https://doi.org/10.1023/A:1020574400259
Issue Date:
DOI: https://doi.org/10.1023/A:1020574400259