What is the risk of nephrotoxicity with nonsteroidal antiinflammatory drugs?
Aspirin and NSAIDs at therapeutic doses generally do not cause renal disease in patients with normal renal function. However, problems such as nephrotic syndrome, acute interstitial nephritis, and acute renal failure have been observed when aspirin and other nonsteroidals are given to patients with abnormal renal function. This can occur as a result of the inhibition of renal prostaglandin production by NSAIDs and the coxibs. Congestive heart failure, hepatic cirrhosis, collagen vascular disease, intravascular volume depletion, and arthrosclerotic heart disease are known contributing factors that may increase the risk of renal failure.