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Published ahead of print on February 1, 2006
Clin J Am Soc Nephrol 1: 236-245, 2006
© 2006 American Society of Nephrology
doi: 10.2215/CJN.00890805
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Mini-Reviews

Update on Cyclooxygenase-2 Inhibitors

Raymond C. Harris, and Matthew D. Breyer

Division of Nephrology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee

Address correspondence to: Dr. Raymond C. Harris, Division of Nephrology, S3322 MCN, Vanderbilt University School of Medicine, Nashville, TN 37232. Phone: 615-322-2150; Fax: 615-343-2675; E-mail: ray.harris{at}vanderbilt.edu

Nonsteroidal anti-inflammatory drugs represent the most commonly used medications for the treatment of pain and inflammation, but numerous well-described side effects can limit their use. Cyclooxygenase-2 (COX-2) inhibitors were initially touted as a therapeutic strategy to avoid not only the gastrointestinal but also the renal and cardiovascular side effects of nonspecific nonsteroidal anti-inflammatory drugs. However, in the kidney, COX-2 is constitutively expressed and is highly regulated in response to alterations in intravascular volume. COX-2 metabolites have been implicated in mediation of renin release, regulation of sodium excretion, and maintenance of renal blood flow. This review summarizes the current state of knowledge about both renal and cardiovascular side effects that are attributed to COX-2 selective inhibitors.




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Renoprotective effects of neuronal NOS-derived nitric oxide and cyclooxygenase-2 metabolites in transgenic rats with inducible malignant hypertension
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