Adam O, Vetter-Kerkhoff C, Schlöndorff D
Medizinische Poliklinik, Klinikum Innenstadt, Maximilians-Universität München.
Med Klin (Munich). 1994 Jun 15;89(6):305-11.
Non-steroidal anti-inflammatory drugs (NSAID) are increasingly used for analgesia, as antirheumatics and to inhibit platelet aggregation. Renal side effects occur mainly in patients at risk, e.g. those with pre-existing renal insufficiency, or when used together with diuretics or a second NSAID.
In these patients, reversible impairment of renal function, disturbance of electrolyte homeostasis, edema and hypertension are quite common. Nephrotic syndrome with or without interstitial nephritis and renal failure is a rare complication of long-term NSAID therapy. Analgesic nephropathy may result from chronic NSAID use. These three renal complications are exemplified by case reports.
Since side effects of NSAIDs are initially reversible, careful observation of patients can prevent chronic illness. Only rarely dialysis or treatment with glucocorticoids is indicated in patients with interstitial nephritis. Given the large number of patients taking NSAIDs, however, renal side effects are rare, and usually have no long-term consequences. Nevertheless, early detection of side effects is of importance for the prevention of long-term medical complications.
非甾体抗炎药（NSAID）越来越多地用于镇痛、作为抗风湿药以及抑制血小板聚集。肾脏副作用主要发生在有风险的患者中，例如那些已有肾功能不全的患者，或者与利尿剂或第二种NSAID联合使用时。
在这些患者中，肾功能的可逆性损害、电解质平衡紊乱、水肿和高血压相当常见。伴有或不伴有间质性肾炎和肾衰竭的肾病综合征是长期NSAID治疗的罕见并发症。镇痛性肾病可能由长期使用NSAID引起。这三种肾脏并发症通过病例报告举例说明。
由于NSAID的副作用最初是可逆的，对患者进行仔细观察可以预防慢性病。间质性肾炎患者很少需要透析或用糖皮质激素治疗。然而，鉴于服用NSAID的患者数量众多，肾脏副作用很少见，而且通常没有长期后果。尽管如此，早期发现副作用对于预防长期医疗并发症很重要。
