Mann J F, Goerig M, Brune K, Luft F C
Medizinische Klinik IV, Universität Erlangen-Nürnberg, Germany.
Clin Nephrol. 1993 Jan;39(1):1-6.
Ibuprofen has recently been introduced as over-the-counter drug in several countries. The question has been raised whether or not the increased availability and use of ibuprofen as over-the-counter drug will be associated with an increased incidence of nephrotoxic side-effects. It is unquestionable that ibuprofen can cause renal damage, including functional acute renal failure, water and electrolyte disorders, and interstitial nephritis. Analgesic nephropathy is not a documented consequence of ibuprofen therapy. Renal side-effects of ibuprofen appear to be dose-dependent, and were not reported at the recommended dosage as over-the-counter drug (0.2-0.8 g/d) except for a single child. Even at anti-inflammatory doses (> 1.6 g/d), renal side-effects are almost exclusively encountered in patients with low intravascular volume and low cardiac output particularly in old age. Alternative analgesic and antipyretic agents display no less risk for renal injury than ibuprofen.
布洛芬最近在几个国家被列为非处方药。有人提出，布洛芬作为非处方药可及性和使用增加是否会与肾毒性副作用发生率增加相关。毫无疑问，布洛芬可导致肾损害，包括功能性急性肾衰竭、水和电解质紊乱以及间质性肾炎。镇痛性肾病并非布洛芬治疗的已记录后果。布洛芬的肾脏副作用似乎与剂量有关，除了一名儿童外，按照非处方药推荐剂量（0.2 - 0.8克/天）未报告有此类副作用。即使在抗炎剂量（>1.6克/天）下，肾脏副作用几乎仅见于血管内容量低和心输出量低的患者，尤其是老年人。其他止痛和解热药物对肾脏损伤的风险并不低于布洛芬。
