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March 9, 1984

Nonsteroidal Anti-inflammatory Drugs Caution Still Indicated

Author Affiliations

University of Colorado School of Medicine Denver; University of Texas Health Science Center Dallas Veterans Administration Medical Center

JAMA. 1984;251(10):1301-1302. doi:10.1001/jama.1984.03340340041024

Nonsteroidal anti-inflammatory drugs (NSAIDs) have become a major component of modern clinical therapeutics. These drugs are popular because of their effectiveness in a wide range of disorders commonly encountered in medical practice, including arthritis, tendonitis, orthopedic injuries, and even dysmenorrhea. While nephrologists would not debate that NSAIDs are clinically effective, the widespread use of these agents has resulted in a growing recognition that the drugs are capable of causing acute deterioration in renal function. Many nephrologists report that NSAIDs now rank behind only aminoglycosides as a cause of nephrotoxic acute renal failure (ARF) in their practices. Exact incidence data are not yet available; it is this important and pertinent issue that Fox and Jick1 address in the current article on NSAIDs and renal failure.

Of the several adverse effects these agents may have on renal function, two are most commonly recognized. The first is a reversible decrement in renal