Currently a large group of nonsteroidal antiinflammatory drugs are widely represented by modern synthetic derivatives. More than 14 major pharmaceutical groups in chemical structure represented by a variety of active ingredients (International Nonproprietary Names, INN) and numerous shopping generics drugs. In modern medicine the main nonsteroidal analgesics-antipyretics are: acetylsalicylic acid (Aspirin), Acetaminophen (Paracetamol, Panadol, Kalpol, Efferalgan), diclofenac sodium (Ortofen, Voltaren, Diklobene), Ibuprofen (Nurofen), ketorolac (Ketanov), indomethacin, phenylbutazone, piroxicam (Roksik), Lornoxicam (Ksefokam), tenoxicam, meloxicam (Movalis), celecoxib (Celebrex), Nimesulide (Nimesil) and others. All of these drugs are very widely used as antiinflammatory, analgesic, antipyretic, antiplatelet agents for numerous indications in many areas of medicine (internal medicine, surgery, traumatology, sports medicine, neurology, gynecology, urology, oncology, ophthalmology, etc.). The most popular drugs in this pharmacological group, such as diclofenac, even included in the list of vital and essential medicines. High popularity and an opportunity to buy on the open market in pharmacies without medical prescriptions provoked uncontrolled without a doctor self. As a result, the occurrence of recorded increasingly serious side effects, one of which is a kidney – analgesic nephropathy. Nephrotoxicity of these drugs due to their common mechanism of action, namely inhibition of the synthesis of vasodilating prostaglandins (PG E2) in renal tissue, which leads to vasoconstriction and deterioration of renal blood flow. Therefore, there are ischemic changes in the kidneys, reduced glomerular filtration. This causes a violation of water-electrolyte metabolism and changes in urine sediment (sodium and water retention, hyperkalemia, hematuria, proteinuria), increase in serum creatinine, appear edema, increased blood pressure. With prolonged use (3–6 months) analgesic nephropathy may develop in the form of interstitial nephritis, nephrotic syndrome, renal papillary necrosis and renal failure due to the direct toxic damage of the differentiated epithelium distal renal tubules (necrobiotic changes with damage to the basement membrane). Also postrenal failure may be due to obstruction of the lumen by the intratubular deskvamation cells remains after papillary (tubular) necrosis of the kidneys. Nephrotoxicity is most pronounced in patients with heart failure, renal failure, hypertension, elderly patients, and when combined with nephrotoxic drugs – gold preparations, antibiotics (aminoglycosides, Afoteritsin B, tetracyclines) and combined multicomponents antiinflammatory drugs. The clinical nephrotoxicity monitoring is recommended in terms of creatinine in the blood in these cases necessarily.
The work is submitted to the International Scientific Conference “Innovative medical technologies” France (Paris), March 18–25, 2015, came to the editorial office оn 19.01.2015.
Библиографическая ссылка
Ermolenko T.I., Karnaukh E.V. Analgesic nephropathy as a limiting factor Widespread use of the nonsteroidal antiinflammatory drugs // Международный журнал экспериментального образования. – 2015. – № 3. – С. 19-20;URL: https://expeducation.ru/ru/article/view?id=7801 (дата обращения: 12.05.2024).