Brater D C
Department of Medicine, Indiana University School of Medicine, Indianapolis.
Semin Arthritis Rheum. 1988 Feb;17(3 Suppl 2):17-22. doi: 10.1016/0049-0172(88)90040-6.
Nonsteroidal antiinflammatory drugs (NSAIDs) can have a variety of effects on renal function. Excluding allergic phenomena, these are directly related to NSAID-induced inhibition of renal synthesis of prostaglandins (PGs). For the most part, renal PGs play important physiological roles only in certain pathologic conditions. Thus, patients without these diseases (such as cardiac, hepatic, or renal compromise) manifest no or only trivial effects on renal function when NSAIDs are administered. This feature is to the advantage of the clinician because it allows prospective identification of patients who are at risk for an adverse renal effect; hence, such effects can be minimized or avoided altogether. To do so requires an understanding of the various roles of PGs in the kidney and thereby the effects that one can observe from NSAIDs. This review focuses on these various roles of renal PGs and on identification of patient groups at risk for adverse renal effects of NSAIDs.
非甾体抗炎药（NSAIDs）可对肾功能产生多种影响。除过敏现象外，这些影响直接与NSAIDs诱导的肾脏前列腺素（PGs）合成抑制有关。在大多数情况下，肾脏PGs仅在某些病理状况下发挥重要的生理作用。因此，没有这些疾病（如心脏、肝脏或肾脏功能不全）的患者在使用NSAIDs时对肾功能无影响或仅有轻微影响。这一特性对临床医生有利，因为它能让医生前瞻性地识别出有肾脏不良反应风险的患者；因此，可将此类影响降至最低或完全避免。要做到这一点，需要了解PGs在肾脏中的各种作用，以及由此可以观察到的NSAIDs的影响。本综述重点关注肾脏PGs的这些不同作用，以及识别有NSAIDs肾脏不良反应风险的患者群体。
