Renal Effects of Nonsteroidal Antiinflammatory Drugs

Abstract

America's population is aging, and there is a direct relationship between advancing age and sensitivity to adverse drug reactions (ADRs). The number of the old old, those 85 years and older, will increase by 114% by the year 2000, and by another 44% in the subsequent 20 years.1 The largest absolute and relative increases are seen and will continue to be seen for unmarried women older than 85 years (women are more sensitive to ADRs than are men). Importantly, the population 95 years of age and older has increased by about twice the rate of the aggregate population 85 years and older. Activity limitations among community‐living elderly rise precipitously with age, afflicting about 12% of those 65 to 74 years old but almost 46% of those 85 years and older.2 It has been estimated that approximately 4.6 million community‐living elderly are limited in activities of daily living (ADLs) or instrumental activities of daily living (IADLs, cognitive impairment),3 and that number may double, triple, or even quadruple in the next 50 years.

Clinical characteristics, causes and outcomes of acute interstitial nephritis in the elderly

“…14 Furthermore, there appears to be a higher risk of AIN in elderly patients from certain drugs such as NSAIDs. 15 A recent Spanish biopsy registry study 16 showed the prevalence of AIN to have increased about threefold in all patients from 1994 to 2009, but in elderly patients specifically this increase was a marked eightfold. This increase was postulated to be due to the increasing biopsy rate in the elderly, as well as increasing use of the drugs that are most commonly implicated in DI-AIN such as antibiotics and NSAIDs.…”

Renal Disease in the Elderly

“…Other important drug groups consist of non-steroidal anti-inflammatory drugs, the diuretics thiazide and frusemide, as well as many other commonly used therapeutic agents. In the elderly, there may be a particular risk with the use of non-steroidal anti-inflammatory drugs [38]. …”

Nefritis tubulointersticial aguda. Revisión bibliográfica

“…El registro español de biopsias renales durante el período 1994-2009, estimó una prevalencia de la NTIA del 3,6 % en los primeros 4 años, encontrando una prevalencia de más del doble (10,5 %) en los siguientes años estudiados. Dicho incremento fue mayor en los pacientes ancianos (> 65 años), oscilando desde un 1,6 hasta un 12,3 %, hallazgos reportados previamente en otros estudios (10,12,(14)(15)(16) .…”