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Kim S, Joo KW. Electrolyte and Acid-base disturbances associated with non-steroidal anti-inflammatory drugs. Electrolyte Blood Press. 2007;5(2):116-25doi: 10.5049/EBP.2007.5.2.116.
Kim, S., & Joo, K. W. (2007). Electrolyte and Acid-base disturbances associated with non-steroidal anti-inflammatory drugs. Electrolyte & blood pressure : E & BP, 5(2), 116-25. https://doi.org/10.5049/EBP.2007.5.2.116
Kim, Sejoong, and Joo, Kwon Wook. "Electrolyte and Acid-base disturbances associated with non-steroidal anti-inflammatory drugs." Electrolyte & blood pressure : E & BP vol. 5,2 (2007): 116-25. doi: https://doi.org/10.5049/EBP.2007.5.2.116
Kim S, Joo KW. Electrolyte and Acid-base disturbances associated with non-steroidal anti-inflammatory drugs. Electrolyte Blood Press. 2007 Dec;5(2):116-25. doi: 10.5049/EBP.2007.5.2.116. Epub 2007 Dec 31. PMID: 24459510; PMCID: PMC3894511.
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Electrolyte Blood Press. 2007 Dec;5(2):116-25. doi: 10.5049/EBP.2007.5.2.116. Epub 2007 Dec 31.

Electrolyte and Acid-base disturbances associated with non-steroidal anti-inflammatory drugs.

Electrolyte & blood pressure : E & BP

Sejoong Kim, Kwon Wook Joo

Affiliations

  1. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.

PMID: 24459510 PMCID: PMC3894511 DOI: 10.5049/EBP.2007.5.2.116

Abstract

Inhibition of renal prostaglandin synthesis by non-steroidal anti-inflammatory drugs (NSAIDs) causes various electrolyte and acid-base disturbances including sodium retention (edema, hypertension), hyponatremia, hyperkalemia, and decreased renal function. Decreased sodium excretion can result in weight gain, peripheral edema, attenuation of the effects of antihypertensive agents, and rarely aggravation of congestive heart failure. Although rare, NSAIDs can cause hyponatremia by reducing renal free water clearance. Hyperkalemia could occur to a degree sufficient to cause cardiac arrhythmias. Renal function can decline sufficiently enough to cause acute renal failure. NSAIDs associated electrolyte and acid-base disturbances are not uncommon in some clinical situations. Adverse renal effects of NSAIDs are generally associated with prostaglandin dependent states such as volume-contracted states, low cardiac output, or other conditions that tend to compromise renal perfusion. All NSAIDs seem to share these adverse effects. In view of many NSAIDs users' susceptibility to renal adverse effects due to their underlying disease or condition, physicians should be cautious in prescribing NSAIDs to susceptible patients.

Keywords: Acute renal failure; Edema; Hyponatremia; Non-steroidal anti-inflammatory agents; Renal tubular acidosis

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