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.