Summary
The acute renal side-effects of nonsteroidal anti-inflammatory drugs are well documented. These include interstitial nephritis, hyperkalaemia, renal tubular acidosis, fluid retention, hypertension and nephrotic syndrome. The long-term effects are less well known. We have carried out a cross-sectional survey of an unselected out-patient population with definite or classical rheumatoid arthritis to determine the prevalence of renal problems in this group. Thirty-four patients (20%) were shown to have an abnormality as defined by our criteria but in the majority this was transient or had been previously recognised. Thirteen patients (8%) had a persistent unexplained abnormality but only 1 had merited renal biopsy using established criteria (Patient 1). We conclude that the long-term use of NSAID's is associated with relatively few renal side-effects.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Kimberley, R.P., Bowden, R.E., Kaiser, H.R., Plotz, P.H. Reduction of renal function by newer nonsteroidal anti-inflammatory drugs. Am J Med 1978, 64, 804–807.
Stillman, M.T., Napier, J., Blackshear, J.L. Adverse effects of nonsteroidal anti-inflammatory drugs on the kidney. Med Clin North Am 1984, 68 (2), 371–385.
Fox, D.A., Jick, H. Nonsteroidal anti-inflammatory drugs and renal disease. JAMA 1984, 251 (10), 1299–1302.
Clive, D.M., Stoff, J.S. Renal syndromes associated with nonsteroidal anti-inflammatory drugs. New Engl J Med 1984, 310, 563–572.
Blackshear, J.L., Napier, J.S., Davidman, M., Stillman, M.T. Renal complications of nonsteroidal anti-inflammatory drugs: identification and monitoring of those at risk. Semin Arthritis Rheum 1985, 14 (3), 163–175.
Atkinson, L.K., Goodship, T.H.J., Ward, M.K. Acute renal failure associated with acute pyelonephritis and consumption of nonsteroidal antiinflammatory drugs. Br Med J 1986, 292, 97–98.
Allander, E., Bucht, H., Lougren, O., Wehle, B. Renal function in RA. Acta Rheum Scand 1963, 116–121.
Solomon, M.I., Gallow, G., Poon, T.P., Goldblat, M.V., Chertkoff, V.T. The kidney in RA. Nephron 1974, 12, 297–310.
Hull, J.H., Hak, L.J., Koch, G.G., Wargin, W.A., Chi, S.L., Mattocks, A.M. Influence of range of renal function and liver disease on predictability of creatinine clearance. Clin Pharmacol Ther 1981, 29, 516–521.
Jeliffe, R.W. Estimation of creatinine clearance when urine cannot be collected. Lancet 1971, 975–976.
Garnett, E.S., Parsons, V., Veall, N. Measurement of glomerular filtration rate in man using (51CR)-EDTA complex. Lancet 1967, 818–819.
Garella, S., Matarese, R.A. Renal effects of prostaglandins and clinical adverse effects of nonsteroidal anti-inflammatory agents. Medicine 1984, 63, 165–181.
Adams, D.H., Howie, A.J., Michael, J., McConkey, B., Bacon, P.A., Adu, D. Nonsteroidal anti-inflammatory drugs and renal failure. Lancet 1986, 57–60.
Unsworth, J., Sturman, S., Lunec, J., Blake, D.R. Renal impairment associated with nonsteroidal anti-inflammatory drugs. Ann Rheum Dis 1987, 46, 233–236.
Pirsen, Y., van Ypersele de Strihou, C. Renal side effects of nonsteroidal anti-inflammatory drugs: clinical relevance. Am J Kidney Dis 1986, VIII(5), 338–344.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Richards, I.M., Fraser, S.M., Capell, H.A. et al. A survey of renal function in outpatients with rheumatoid arthritis. Clin Rheumatol 7, 267–271 (1988). https://doi.org/10.1007/BF02204466
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02204466