Center for Clinical Pharmaceutical Sciences, Kumamoto University, Chuo-ku, Kumamoto, Japan.
Life Sci. 2012 Dec 17;91(25-26):1304-8. doi: 10.1016/j.lfs.2012.09.018. Epub 2012 Oct 12.
Acetaminophen is a safe antipyretic and analgesic drug within the clinically recommended dosage range, but overdose can cause fatal liver and or kidney damage. Most of the nonsteroidal anti-inflammatory drugs (NSAIDs) exert their analgesic effect via inhibition of cyclooxygenase, which also results in a reduction of renal blood flow. Therefore, the use of NSAIDs in pain treatment for chronic kidney disease (CKD) patients is of particular concern. Acetaminophen lacks the anti-inflammatory and anti-coagulatory properties of the NSAIDs. In this study, we investigate whether acetaminophen has an impact on the progression of renal failure.
Acetaminophen (150mg/kg/day or 750mg/kg/day) or indomethacin (5mg/kg/day) was orally administered to adenine-induced chronic renal failure model rats for 4weeks. The plasma concentrations of acetaminophen and its metabolites were measured during the treatment period; renal function and oxidative stress in the rats were also monitored.
Indomethacin significantly decreased the survival rate of renal failure model rats. In contrast, both low (150mg/kg) and high (750mg/kg) doses of acetaminophen improved the survival rate. The progression of renal failure was attenuated by acetaminophen (750mg/kg) after administration for 2weeks. The metabolites of acetaminophen were found to accumulate in plasma. Plasma glutathione concentration had significantly recovered after acetaminophen administration.
Acetaminophen has no effect on the progression of renal damage in adenine-induced renal failure model rats. This result is in part due to acetaminophen's antioxidant activity. These results suggest that acetaminophen is a suitable analgesic agent for treating CKD patients.
扑热息痛在临床推荐剂量范围内是一种安全的解热镇痛药,但过量会导致致命的肝或肾损伤。大多数非甾体抗炎药(NSAIDs)通过抑制环氧化酶发挥其镇痛作用,这也会导致肾血流量减少。因此,在慢性肾病(CKD)患者的疼痛治疗中,使用 NSAIDs 尤其令人关注。扑热息痛缺乏 NSAIDs 的抗炎和抗凝血特性。在这项研究中,我们研究了扑热息痛是否会影响肾衰竭的进展。
在 4 周的时间内,通过口服给予腺嘌呤诱导的慢性肾衰竭模型大鼠扑热息痛(150mg/kg/天或 750mg/kg/天)或吲哚美辛(5mg/kg/天)。在治疗期间测量了扑热息痛及其代谢物的血浆浓度;还监测了大鼠的肾功能和氧化应激。
吲哚美辛显著降低了肾衰竭模型大鼠的存活率。相比之下,低(150mg/kg)和高(750mg/kg)剂量的扑热息痛均提高了存活率。扑热息痛(750mg/kg)给药 2 周后可减轻肾衰竭的进展。在给药后,扑热息痛的代谢物在血浆中积累。血浆谷胱甘肽浓度在扑热息痛给药后显著恢复。
扑热息痛对腺嘌呤诱导的肾衰竭模型大鼠的肾损伤进展没有影响。这一结果部分归因于扑热息痛的抗氧化活性。这些结果表明扑热息痛是治疗 CKD 患者的合适镇痛药。