Acute intrinsic renal failure induced by indomethacin. Role of prostaglandin synthetase inhibition

J. T. McCarthy, Vicente Torres, J. C. Romero, D. N. Wochos, J. A. Velosa

Research output: Contribution to journalArticle

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Abstract

Nonsteroidal anti-inflammatory agents are often used to treat acute inflammatory arthritis because of their effectiveness and the infrequency of reported serious side effects. This report describes two patients who had acute intrinsic renal failure that was triggered by indomethacin. Both patients were volume contracted and had other circulatory impairments. Azotemia was so severe as to require temporary hemodialysis in one patient. Intrinsic renal function began to recover within 5 days after discontinuation of indomethacin. At the time that recovery began, urinary prostaglandin excretion increased in both patients. A detailed review of pertinent experimental data indicates that renal production of prostaglandin is an important compensatory response that helps to maintain renal function in the face of diminished renal blood flow. Our cases provide clinical support for this hypothesis and illustrate the fact that indomethacin, by interfering with this protective mechanism, can lead to acute intrinsic renal failure. Clinicians must be aware of this possible complication and use the nonsteroidal anti-inflammatory drugs with caution in patients who have compromised prerenal status.

Original languageEnglish (US)
Pages (from-to)289-296
Number of pages8
JournalMayo Clinic Proceedings
Volume57
Issue number5
StatePublished - 1982

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Prostaglandin-Endoperoxide Synthases
Acute Kidney Injury
Indomethacin
Kidney
Prostaglandins
Azotemia
Renal Circulation
Non-Steroidal Anti-Inflammatory Agents
Arthritis
Renal Dialysis
Anti-Inflammatory Agents
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Medicine(all)

Cite this

McCarthy, J. T., Torres, V., Romero, J. C., Wochos, D. N., & Velosa, J. A. (1982). Acute intrinsic renal failure induced by indomethacin. Role of prostaglandin synthetase inhibition. Mayo Clinic Proceedings, 57(5), 289-296.

Acute intrinsic renal failure induced by indomethacin. Role of prostaglandin synthetase inhibition. / McCarthy, J. T.; Torres, Vicente; Romero, J. C.; Wochos, D. N.; Velosa, J. A.

In: Mayo Clinic Proceedings, Vol. 57, No. 5, 1982, p. 289-296.

Research output: Contribution to journalArticle

McCarthy, JT, Torres, V, Romero, JC, Wochos, DN & Velosa, JA 1982, 'Acute intrinsic renal failure induced by indomethacin. Role of prostaglandin synthetase inhibition', Mayo Clinic Proceedings, vol. 57, no. 5, pp. 289-296.
McCarthy, J. T. ; Torres, Vicente ; Romero, J. C. ; Wochos, D. N. ; Velosa, J. A. / Acute intrinsic renal failure induced by indomethacin. Role of prostaglandin synthetase inhibition. In: Mayo Clinic Proceedings. 1982 ; Vol. 57, No. 5. pp. 289-296.
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