NON-STEROIDAL ANTI-INFLAMMATORY DRUGS AND RENAL DISEASES

Qahil Ibraimi, Nexhbedin Kahremani

Abstract

Non-steroidal anti-inflammatory drugs (NSAIDs) have always been used to treat pain, even though studies exist reporting and verifying undesirable effects especially nephrotoxicity and alimentary tract toxicity. The mechanism of action of NSAIDs is based on nonselective inhibition of isoenzymes of cyclooxygenases: Cyclooxygenase-1 (COX-1), Cyclooxygenase-2 (COX-2), and Cyclooxygenase-3 (COX-3). The most common side effects of NSAIDs affect the alimentary tract, renal system, liver, and respiratory system (in the form of various allergies), etc. The purpose of this scientific research paper is: to document and report the side effects of NSAIDs upon the kidneys. Materials and methods: In a cohort study, 60 patients with an average age of 58 years old (± 5.00 years) have been examined. Of the examined patients, 35 patients were females and 25 were males. The average duration of the pathophysiological state was 48 years (± 2.00 years). The study also included the control group of patients [healthy individuals (voluntary blood donors)] compromising 60 individuals, of which 30 were females and 30 were males. The average age of the control group patients was 58 years old (± 5.00 years). During the duration of the study, all of the patients were treated with NSAIDs (with short breaks) and Methotrexate (MTH) with dose of 7.5 – 10 mg (for 10 weeks). During the laboratory examination which were utilized and performed to discover nephrotoxicity, we tested for concentration of erythrocytes (Rbc), haemoglobin (Hb), haematocrit (Htc), urea, creatinine, GFR (by Cockcroft-Gault formula), albuminuria, C-reactive protein (CRP), rheumatic factor (RhF), and urinary enzymes (cystatin-C, ßNAG (N-acetyl-B-D-glycosaminidase), AAP (Alanine aminopeptidase), ?-GT). For examination of concentration of all tested biomarkers, the colorimetric analysis method was applied on a Cobas Integra 400® plus device.Results: All of the patients treated with NSAIDs, regardless of the type of drug, showed an increase of all of the examined biomarkers, with a significant difference of p<0.0005 – 0.0001, in comparison to the control group, consisting of healthy individuals. Statistical processing: We applied the standard deviation measure(X±DS), arithmetic mean value, and the Mann-Whitney U test in order to analyse and process the obtained values and parameters. Conclusion: From this scientific work we may conclude that our results are in accordance and compliance with the already published results on the undesirable and noxious effects of the NSAIDs upon the kidneys. Thus, we suggest NSAIDs utilization, application, and administration be extremely rational, especially for patients suffering from diabetic nephropathy, and other renal pathologies.

Pages: 123 - 127