What NSAIDs to be used in mild renal compromise

What NSAIDs to be used in mild renal compromise?

The nonacetylated salicylates are poor COX inhibitors and may have less effect on GFR. The hope was that the selective COX-2 inhibitors would have less renal effects than the traditional NSAIDs. However, COX-2 is found in the glomeruli and renal vasculature. COX-2 appears to be the dominant contributor to salt and water homeostasis, and COX-1 has a more dominant role in GFR maintenance. Thus, in practice, the selective COX-2 inhibitors have similar effects on blood pressure and induction of edema as the traditional NSAIDs.


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