Abstract:
PURPOSE OF REVIEW:Strong epidemiological and pathologic evidence associates NSAIDs with kidney disease, both acute and chronic. Hence, the usage of NSAIDs has decreased in patients with, or at risk for, chronic kidney disease (CKD). Coupled with this has been a rise in use of opioids and other non-NSAID alternatives, which do come with significant, and underrecognized, risk of nonrenal adverse events. We review the literature to understand if this shift is appropriate or deleterious. RECENT FINDINGS:NSAIDs do have a low but tangible risk in causing acute kidney injury, electrolyte imbalances, and increasing blood pressure. However, their role in causing progressive kidney disease is due to long-term usage in high cumulative dosages, and the use of NSAIDs in combination with other agents. Alternatives such as opioids, tramadol, gabapentin and baclofen have weak evidence to support their use and strong evidence to show their harm in patients with CKD. SUMMARY:Tradeoffs are inherent in using active pharmaceuticals, and NSAIDs are no exception. Balancing potential benefits with possible adverse effects around pain management should be a part of every conversation for patients with kidney disease.
journal_name
Curr Opin Nephrol Hypertensjournal_title
Current opinion in nephrology and hypertensionauthors
Sriperumbuduri S,Hiremath Sdoi
10.1097/MNH.0000000000000473subject
Has Abstractpub_date
2019-03-01 00:00:00pages
163-170issue
2eissn
1062-4821issn
1473-6543journal_volume
28pub_type
杂志文章,评审abstract:PURPOSE OF REVIEW:Several factors are now known to contribute to the development and progression of nephropathy, particularly in diabetes. In recent times, there has been surge of interest in the role of small noncoding RNA, with several reports focusing on the effects of microRNAs on their target genes that are of rel...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/01.mnh.0000437612.50040.ae
更新日期:2014-01-01 00:00:00
abstract::Heat shock proteins, or stress proteins, are molecular chaperones responsible for protein processing and protection against cellular injury through the prevention of inappropriate peptide interactions. The distribution of individual stress proteins varies between regions of the kidney and within subcellular compartmen...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/00041552-199807000-00010
更新日期:1998-07-01 00:00:00
abstract::Chronic renal disease evolves to end-stage renal failure through events, including enhanced intraglomerular pressure and plasma protein ultrafiltration, mediated at least in part by angiotensin II. Angiotensin-converting enzyme inhibitors reduce intracapillary pressure and ameliorate glomerular size-selective function...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/00041552-199709000-00014
更新日期:1997-09-01 00:00:00
abstract:PURPOSE OF REVIEW:Autonomic dysfunction is well recognized in chronic kidney disease. The baroreflex arc is an important component of the autonomic nervous system and influences vasodilatation and heart rate in response to information derived from baroreceptors located in the aorta and common carotid arteries. Appropri...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/01.mnh.0000185981.02578.0e
更新日期:2005-11-01 00:00:00
abstract::Data suggest that ischemic renal disease secondary to atherosclerotic renal artery stenosis is a prevalent health problem. Atherosclerotic renal artery stenosis is a rapidly progressive process that can result in end-stage renal disease. Renal arteriography is the current diagnostic method of choice for the demonstrat...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/00041552-199303000-00007
更新日期:1993-03-01 00:00:00
abstract:PURPOSE OF REVIEW:Structural biology is one of the most informative disciplines available to biochemical research. It unites technologies that can reveal high-resolution (often atomic) details of the inner workings of biochemical systems. These insights are crucial for an understanding of basic life processes, such as ...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/00041552-200307000-00012
更新日期:2003-07-01 00:00:00
abstract::The prevalence of hypertension is extremely high in end-stage renal disease, and is a probable contributor to the epidemic of cardiovascular disease in end-stage renal disease. However, the paucity of prospective, randomized clinical trials makes it difficult to precisely define treatment strategies. Therefore, at pre...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/00041552-200005000-00012
更新日期:2000-05-01 00:00:00
abstract:PURPOSE OF REVIEW:Defective transduction of the dopamine receptor signal in the kidney has been shown to be important in the pathogenesis of hypertension This review will discuss the genetic mechanism for the defective renal dopaminergic function and the interaction with other gene variant products in the pathogenesis ...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/00041552-200303000-00010
更新日期:2003-03-01 00:00:00
abstract::The parathyroid normally has very few cells in mitosis but it retains the potential to proliferate. In-vivo studies in rats have demonstrated that hypocalcaemia and high serum phosphate both lead to an increase in the number of proliferating cells, which is relevant to the increased parathyroid cell proliferation in c...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/00041552-199707000-00004
更新日期:1997-07-01 00:00:00
abstract::It has been 6 years since the first reports of the use of recombinant human erythropoietin for the treatment of renal anemia appeared in the medical literature. During this period, erythropoietin has become established as a safe and highly effective therapy, and it is currently being evaluated for other nonrenal types...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/00041552-199212000-00005
更新日期:1992-12-01 00:00:00
abstract:PURPOSE OF REVIEW:In the present review, we aim to describe the state of knowledge concerning antibody-mediated rejection (ABMR) spectrum and diagnosis criteria before analyzing the present and future promising leads regarding ABMR prognosis markers and treatment. RECENT FINDINGS:Recent studies regarding complement-bi...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/MNH.0000000000000069
更新日期:2014-11-01 00:00:00
abstract::The cells of the renal medulla osmotically adapt to chronic alterations in extracellular tonicity by appropriate changes in the intracellular contents of organic osmoeffectors. The major organic osmolytes are glycerophosphorylcholine, betaine, myo-inositol, sorbitol, and, possibly, taurine. When the concentrations of ...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/00041552-199210000-00007
更新日期:1992-10-01 00:00:00
abstract:PURPOSE OF REVIEW:The renal distal tubule has been considered for a long time as the main cellular target of aldosterone, where the hormone enhances sodium reabsorption and potassium secretion. However, other cell types in nonepithelial tissues, such as the heart, the vessels, adipose tissue, and macrophages, are now a...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/MNH.0b013e32834fb25b
更新日期:2012-03-01 00:00:00
abstract:PURPOSE OF REVIEW:Non-valvular atrial fibrillation is common in patients with severe chronic kidney disease (CKD) and historically patients have been treated with vitamin K antagonists (VKA). However, these agents have questionable efficacy and are associated with increased bleeding risk. Non-vitamin K oral anticoagula...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/MNH.0000000000000443
更新日期:2018-11-01 00:00:00
abstract:PURPOSE OF REVIEW:The analysis of renal tissue from kidney biopsies by histology, electron microscopy and immunohistology represents the current standards used to establish a specific diagnosis in nephrology. Recent progress in gene expression-based tissue analysis may provide fundamentally novel information in renal b...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/00041552-200405000-00008
更新日期:2004-05-01 00:00:00
abstract:PURPOSE OF REVIEW:This review examines recent advances in understanding of how clinical outcomes for hemodialysis patients may be improved by achieving longer or more frequent treatment times, lower ultrafiltration rates (UFRs), improving nutritional status, and individualizing dialysate composition. This review also d...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/MNH.0b013e328365b34c
更新日期:2013-11-01 00:00:00
abstract:PURPOSE OF REVIEW:To summarize recent evidence regarding the role of distal nephron segments other than the macula densa in sensing the tubular environment and transmitting this signal to the adjacent vasculature. RECENT FINDINGS:In addition to the classical contact site between the macula densa plaque and the afferen...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/MNH.0b013e32831daf54
更新日期:2009-01-01 00:00:00
abstract::Increasing evidence implicates reactive oxygen species in the pathogenesis of hypertension and its cardiovascular complications. By altering the balance in the endothelium between vasoconstrictors such as thromboxane and isoprostanes and vasodilators such as nitric oxide, reactive oxygen species contribute to endothel...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/00041552-199809000-00008
更新日期:1998-09-01 00:00:00
abstract::The majority of hemodialysis patients die from cardiovascular disease. However, the contribution of myocardial infarction to mortality is relatively minor, despite the fact that coronary artery disease is common in uremic patients. Hypertension seems to be the major risk factor for the development of atherosclerosis i...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/00041552-199309000-00013
更新日期:1993-09-01 00:00:00
abstract:PURPOSE OF REVIEW:To describe the direct and indirect effects of estrogen on bone with special emphasis on the analysis of the recent findings related to the putative role of FGF23 in the estrogen-dependent parathyroid hormone (PTH) suppression. RECENT FINDINGS:Estrogens act directly on bone cells, downregulating oste...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/MNH.0b013e328338f508
更新日期:2010-07-01 00:00:00
abstract:PURPOSE OF REVIEW:The purpose of this mini-review is to highlight some unresolved questions and controversies in the evolving story of apolipoprotein L1 (APOL1) nephropathy. RECENT FINDINGS:We highlight studies that introduce complexity in unraveling the mechanisms whereby APOL1 risk variant alleles cause disease. The...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/MNH.0000000000000462
更新日期:2019-01-01 00:00:00
abstract::Vascular endothelial growth factor is a diffusible endothelial cell-specific mitogen and angiogenic factor that can also increase vascular permeability. The vascular endothelial growth factor receptors are specifically expressed on the cell surface of vascular endothelial cells. Recent studies point to vascular endoth...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/00041552-199601000-00008
更新日期:1996-01-01 00:00:00
abstract::The L-arginine: nitric oxide pathway is widely recognized as an important regulator of cell function and communication in a variety of physiological and pathophysiological situations. Recent advances in the biochemistry and molecular biology of nitric oxide synthases have contributed significantly to our understanding...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/00041552-199301000-00018
更新日期:1993-01-01 00:00:00
abstract:PURPOSE OF REVIEW:The direct oral anticoagulants (DOACs) have emerged as an effective and safe alternative to vitamin K antagonists (VKAs) for stroke and venous thromboembolism (VTE) prevention. However, patients with chronic kidney disease (CKD) experience an increase in the risk of both thromboembolism and bleeding, ...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/MNH.0000000000000493
更新日期:2019-05-01 00:00:00
abstract:PURPOSE OF REVIEW:Mammalian target of rapamycin (mTOR) is an evolutionarily conserved protein kinase. mTOR forms two distinct functional multiprotein kinase complexes that mutually phosphorylate different substrates and regulate a wide array of essential cellular processes including translation, transcription and autop...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/MNH.0b013e3283520f38
更新日期:2012-05-01 00:00:00
abstract::Substantial evidence indicates that the adverse effects of hypertension on the kidney depend on the degree to which systemic blood pressure elevations are transmitted to the renal microvasculature. Such blood pressure transmission and consequent susceptibility to hypertensive renal damage is markedly exacerbated in st...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/00041552-200201000-00011
更新日期:2002-01-01 00:00:00
abstract:PURPOSE OF REVIEW:The aim is to review data on the epidemiology of fibroblast growth factor 23 (FGF23) and adverse clinical outcomes in chronic kidney disease (CKD) and introduce recent insights into the pathophysiology behind the observed relationships. RECENT FINDINGS:End-stage renal disease and cardiovascular disea...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/MNH.0b013e328351a391
更新日期:2012-05-01 00:00:00
abstract:PURPOSE OF REVIEW:The success of any given kidney transplant is closely tied to the ability to monitor patients and responsively change their medications. Transplant monitoring is still, however, dependent on relatively old technologies: serum creatinine levels, urine output, blood pressure, blood glucose and histopath...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/01.mnh.0000247499.64291.52
更新日期:2006-11-01 00:00:00
abstract:PURPOSE OF REVIEW:There is currently a major debate on the mechanisms of albuminuria, and this review appraises recent studies in this area. RECENT FINDINGS:The traditional view of albuminuria is that it is the result of damage to an essentially impermeable glomerular barrier. However, over the years, critical evidenc...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/MNH.0b013e32832cb96a
更新日期:2009-07-01 00:00:00
abstract:PURPOSE OF REVIEW:We discuss how recent findings obtained in disorders of phosphate metabolism in humans and in animal models have provided insights into the pathogenesis of renal stone formation and bone demineralization. RECENT FINDINGS:Mice that are null for the sodium-phosphate cotransporter (NPT)2a gene (NPT2a(-/...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/00041552-200411000-00015
更新日期:2004-11-01 00:00:00