The Role of Non-Steroidal Anti-Inflammatory Drugs in Renal Colic

Davenport, Kim; Waine, Elizabeth

doi:10.3390/ph3051304

Cited by 32 publications

(27 citation statements)

References 27 publications

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“…Other theories could also contribute to this behavior of the ureteric calculi, including the kidney response to obstruction by reducing the glomerular filtration rate, which results in reducing the pressure in the renal pelvis, which also potentially helps the upward stone migration. Moreover, the use of nonsteroidal anti-inflammatory drugs for relieving renal colic reduces the glomerular filtration rate by interrupting the renal pelvis pacemaker cells, thus resulting in reducing the ureteric peristalsis 12. This could be a contributing factor in the process of retrograde migration of the ureteric stones, however, the patient denied taking any of these medications.…”

Section: Discussionmentioning

confidence: 99%

Upward migration of ureteric stone in a military trainer: a case report

Fallatah¹,

Tahaineh²,

Mughli³

et al. 2017

RRU

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Retrograde ureteric stone migration is an extremely rare phenomenon with only one previously reported case in the literature. We report on a case of upward spontaneous migration of a ureteric stone in a 39-year-old male military trainer in Saudi Arabia who was diagnosed with upper left ureteric stone based on non-contrast spiral computerized tomography kidney ureter bladder (CT-KUB) scan. The plan was to treat the patient conservatively with alpha blockers and oral hydration. Two weeks after treatment started, repeated CT-KUB scan revealed an upward migration of the stone to the left renal calyx. Accordingly, we highly recommend performing a prior stone localizing imaging test to avoid unnecessary procedures or operations.

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Section: Discussionmentioning

confidence: 99%

Upward migration of ureteric stone in a military trainer: a case report

Fallatah¹,

Tahaineh²,

Mughli³

et al. 2017

RRU

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“…Factors that stimulate synthesis of prostaglandins include bradykinin, antidiuretic hormone, and angiotensin II (24). Prostaglandins promote glomerular afferent arteriolar vasodilatation and increase vascular permeability, resulting in increased urine output and renal pelvic pressure (25,26). Inhibition of prostaglandin production also reduces ureteric edema and inflammation and enables better drainage, all of which act to reduce ureteric activity or peristalsis.…”

Section: Discussionmentioning

confidence: 99%

Effect of the NSAID Diclofenac on ^99mTc-MAG3 and ^99mTc-DTPA Renography

Mustafa

Elgazzar

2013

J Nucl Med

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Renal function and disease are commonly evaluated by radionuclide studies. The choice of radiopharmaceutical agent for various studies is crucial for proper interpretation. 99m Tcmercaptoacetyltriglycine ( 99m Tc-MAG3) is excreted almost exclusively by the renal tubules, whereas 99m Tc-diethylenetriamine pentaacetic acid ( 99m Tc-DTPA) is predominantly excreted by glomerular filtration. The present study compared the effect of the nonsteroidal antiinflammatory drug (NSAID) diclofenac, which is the most commonly used drug to relieve kidney pain, on the kinetic behavior of administered 99m Tc-MAG3 and 99m Tc-DTPA in experimental animals. Methods: Two groups of 12 New Zealand White rabbits ( 99m Tc-MAG3 and 99m Tc-DTPA) were used for the renography. Each rabbit served as its own control. The animals were given 60 mL of saline intravenously 30 min before each renographic study. A baseline study (control) was done by injecting 48 MBq (1.3 mCi) of 99m Tc-MAG3, and renography was performed. Two days later, a single intravenous dose of diclofenac (2 mg/kg) (treated animals) was given, and after 20 min, 99m Tc-MAG3 renography was performed. This procedure was repeated for the 99m Tc-DTPA group after administration of 96 MBq (2.6 mCi) of the tracer. Dynamic images (as 2-s frames for the first minute and 30-s frames for the next 30 min on a 64 · 64 matrix) were acquired using a g-camera equipped with a low-energy highresolution collimator interfaced with a computer. Regions of interest were drawn over the whole kidneys. Time-activity curves were generated from the region of interest. Time to peak activity (T max ), time from peak to 50% activity (T 1/2 ), and the uptake slope of each kidney were calculated from the renograms for control and treated rabbits. Results: Administration of diclofenac shifted the experimental renogram curves to the right, compared with the control curves, indicating that there was a delayed renal uptake of the 2 tracers and clearance of the radioactivity. The calculated average values of T max for control and treated rabbits using 99m Tc-MAG3 were 1.8 6 0.5 and 6.35 6 0.4 min, respectively, whereas those of 99m Tc-DTPA were 3.4 6 0.4 and 18.2 6 2 min, respectively. The T 1/2 for control and treated rabbits for 99m Tc-MAG3 were 3.2 6 0.07 and 6.6 6 0.07 min, respectively, whereas those for 99m Tc-DTPA were 10.1 6 1 and 35 6 4 min, respectively. The differences were statistically significant (P , 0.05). Conclusion: This study showed that diclofenac delayed both T max and T 1/2 . The NSAID-induced kinetic changes were considerably greater for 99m Tc-DTPA than for 99m Tc-MAG3. On the basis of these findings, it is suggested that 99m Tc-MAG3 be used to perform renography for studies involving the use of NSAID administration to decrease any change that may occur due to the type of tracer and not to the condition of the kidney.

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“…NSAIDs also decrease inflammation and oedema, reducing obstruction and therefore alleviating symptoms. 7 It is important to remember that there are important side-effects associated with NSAIDs. For example, there is a significant increased cardiovascular risk with high-dose NSAIDs, including cardiac decompensation, heart failure and cardiovascular events.…”

Section: Management Analgesiamentioning

confidence: 99%

“…For example, there is a significant increased cardiovascular risk with high-dose NSAIDs, including cardiac decompensation, heart failure and cardiovascular events. 7 As a result of this, NSAIDs are contraindicated in patients with New York Heart Association class II-IV congestive cardiac failure. 1 Although paracetamol is often thought of as a weaker analgesic, intravenous paracetamol has been directly compared to the efficacy of opioids in the management of acute renal colic.…”

Section: Management Analgesiamentioning

confidence: 99%