May 16, 2016 - NSAIDs and the Kidney

Question 1

Renal Prostaglandins

Answer 1

Renal prostaglandins dilate the afferent arteriole to allow more bloodflow to enter the kidney. NSAIDs inhibit this.

In healthy people, they don’t rely on prostaglandins very much to regulate their kidney, so nothing bad happens if you take NSAIDs, however in people with kidney disease who are constantly relying on NSAIDs to keep their afferent arteriole open, taking NSAIDs can severely damage the kidney.

Question 2

Effects of Renal Prostaglandins

Answer 2

1. Afferent vasodilation
2. Increase renin release
3. Decrease ADH response
4. Inhibit tubular Na+ resorption

Question 3

NSAIDs + ACEi

Answer 3

A bad bad bad combination.

ACEi dilate the efferent arteriole, and NSAIDs constrict the afferent. Very little blood will get to the kidney and can cause AKI.

Question 4

Prostaglandins and Renin

Answer 4

Prostaglandins increase renin release