Effect of rofecoxib on the glomerular filtration rate, proteinuria and the renin-angiotensin-aldosterone system in elderly subjects with chronic renal impairment

M. Horackova, O. Schück, R. Komers, J. Charvat, V. Teplan, M. Kvapil

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Considering the increasing popularity and prescribing of specific COX-2 inhibitors, a new class of NSAIDs lacking gastrointestinal side effects, the evaluation of their effects on renal function has become very important. Objective: The aim of the study was to evaluate the effect of rofecoxib on GFR, proteinuria and the renin-angiotensin-aldosterone system (RAAS) in elderly patients with chronic renal impairment under controlled conditions of water and salt intake. Subjects: There were ten patients (average age 67 years, range 53 - 80 years) with analgesic or vascular nephropathy (average GFR 54 ml/min/1.73 m2, range 30-79 ml/min/1.73 m2) given 25 mg rofecoxib daily for seven days under balanced conditions of water and sodium metabolism (salt intake 6 - 8 g/24 hours). Methods: The effect of rofecoxib on GFR measured using inulin clearance (Cin), creatinine clearance (CCr) serum cystatin C concentration (Scystatin), tubular creatinine secretion (using the ratio CCr/Cin), 24-hour urinary excretion of albumin (Ualb V) and prostaglandins (UPGE2 V and UPGFα V), basal and stimulated plasma renin activity (PRA) and serum aldosterone concentration (Saldosterone) was evaluated before and on Day 7 during rofecoxib treatment. Results: Rofecoxib did not significantly change Cin, CCr, Scystatin, CCr/Cin and U'alb V. However, UPGE2 V and UPGFα V were decreased during rofecoxib administration (p=0.059 and p=0.024, respectively). Rofecoxib attenuated the stimulated rise of PRA and Saldosterone (p=0.019 and p=0.008, respectively). Conclusions: Short-term rofecoxib administration was not associated with significant change in GFR in elderly patients with moderate chronic renal impairment under conditions of balanced salt and water metabolism despite significant attenuation of RAAS activity. Since the CCr/Cin ratio did not change in our study, we assume rofecoxib to have no influence on creatinine tubular secretion.

Original languageEnglish (US)
Pages (from-to)413-419
Number of pages7
JournalInternational Journal of Clinical Pharmacology and Therapeutics
Volume43
Issue number9
StatePublished - Sep 2005
Externally publishedYes

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Angiotensins
Renin-Angiotensin System
Aldosterone
Glomerular Filtration Rate
Proteinuria
Renin
Kidney
Creatinine
Cystatin C
Salts
Serum
Metabolism
Water
Plasmas
rofecoxib
Inulin
Cyclooxygenase 2 Inhibitors
Non-Steroidal Anti-Inflammatory Agents
Drinking
Prostaglandins

Keywords

  • Albuminuria
  • Chronic renal impairment
  • Glomerular filtration rate
  • Renin-angiotensin-aldosterone system
  • Rofecoxib

ASJC Scopus subject areas

  • Toxicology
  • Pharmacology (medical)

Cite this

Effect of rofecoxib on the glomerular filtration rate, proteinuria and the renin-angiotensin-aldosterone system in elderly subjects with chronic renal impairment. / Horackova, M.; Schück, O.; Komers, R.; Charvat, J.; Teplan, V.; Kvapil, M.

In: International Journal of Clinical Pharmacology and Therapeutics, Vol. 43, No. 9, 09.2005, p. 413-419.

Research output: Contribution to journalArticle

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title = "Effect of rofecoxib on the glomerular filtration rate, proteinuria and the renin-angiotensin-aldosterone system in elderly subjects with chronic renal impairment",
abstract = "Considering the increasing popularity and prescribing of specific COX-2 inhibitors, a new class of NSAIDs lacking gastrointestinal side effects, the evaluation of their effects on renal function has become very important. Objective: The aim of the study was to evaluate the effect of rofecoxib on GFR, proteinuria and the renin-angiotensin-aldosterone system (RAAS) in elderly patients with chronic renal impairment under controlled conditions of water and salt intake. Subjects: There were ten patients (average age 67 years, range 53 - 80 years) with analgesic or vascular nephropathy (average GFR 54 ml/min/1.73 m2, range 30-79 ml/min/1.73 m2) given 25 mg rofecoxib daily for seven days under balanced conditions of water and sodium metabolism (salt intake 6 - 8 g/24 hours). Methods: The effect of rofecoxib on GFR measured using inulin clearance (Cin), creatinine clearance (CCr) serum cystatin C concentration (Scystatin), tubular creatinine secretion (using the ratio CCr/Cin), 24-hour urinary excretion of albumin (Ualb V) and prostaglandins (UPGE2 V and UPGFα V), basal and stimulated plasma renin activity (PRA) and serum aldosterone concentration (Saldosterone) was evaluated before and on Day 7 during rofecoxib treatment. Results: Rofecoxib did not significantly change Cin, CCr, Scystatin, CCr/Cin and U'alb V. However, UPGE2 V and UPGFα V were decreased during rofecoxib administration (p=0.059 and p=0.024, respectively). Rofecoxib attenuated the stimulated rise of PRA and Saldosterone (p=0.019 and p=0.008, respectively). Conclusions: Short-term rofecoxib administration was not associated with significant change in GFR in elderly patients with moderate chronic renal impairment under conditions of balanced salt and water metabolism despite significant attenuation of RAAS activity. Since the CCr/Cin ratio did not change in our study, we assume rofecoxib to have no influence on creatinine tubular secretion.",
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T1 - Effect of rofecoxib on the glomerular filtration rate, proteinuria and the renin-angiotensin-aldosterone system in elderly subjects with chronic renal impairment

AU - Horackova, M.

AU - Schück, O.

AU - Komers, R.

AU - Charvat, J.

AU - Teplan, V.

AU - Kvapil, M.

PY - 2005/9

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N2 - Considering the increasing popularity and prescribing of specific COX-2 inhibitors, a new class of NSAIDs lacking gastrointestinal side effects, the evaluation of their effects on renal function has become very important. Objective: The aim of the study was to evaluate the effect of rofecoxib on GFR, proteinuria and the renin-angiotensin-aldosterone system (RAAS) in elderly patients with chronic renal impairment under controlled conditions of water and salt intake. Subjects: There were ten patients (average age 67 years, range 53 - 80 years) with analgesic or vascular nephropathy (average GFR 54 ml/min/1.73 m2, range 30-79 ml/min/1.73 m2) given 25 mg rofecoxib daily for seven days under balanced conditions of water and sodium metabolism (salt intake 6 - 8 g/24 hours). Methods: The effect of rofecoxib on GFR measured using inulin clearance (Cin), creatinine clearance (CCr) serum cystatin C concentration (Scystatin), tubular creatinine secretion (using the ratio CCr/Cin), 24-hour urinary excretion of albumin (Ualb V) and prostaglandins (UPGE2 V and UPGFα V), basal and stimulated plasma renin activity (PRA) and serum aldosterone concentration (Saldosterone) was evaluated before and on Day 7 during rofecoxib treatment. Results: Rofecoxib did not significantly change Cin, CCr, Scystatin, CCr/Cin and U'alb V. However, UPGE2 V and UPGFα V were decreased during rofecoxib administration (p=0.059 and p=0.024, respectively). Rofecoxib attenuated the stimulated rise of PRA and Saldosterone (p=0.019 and p=0.008, respectively). Conclusions: Short-term rofecoxib administration was not associated with significant change in GFR in elderly patients with moderate chronic renal impairment under conditions of balanced salt and water metabolism despite significant attenuation of RAAS activity. Since the CCr/Cin ratio did not change in our study, we assume rofecoxib to have no influence on creatinine tubular secretion.

AB - Considering the increasing popularity and prescribing of specific COX-2 inhibitors, a new class of NSAIDs lacking gastrointestinal side effects, the evaluation of their effects on renal function has become very important. Objective: The aim of the study was to evaluate the effect of rofecoxib on GFR, proteinuria and the renin-angiotensin-aldosterone system (RAAS) in elderly patients with chronic renal impairment under controlled conditions of water and salt intake. Subjects: There were ten patients (average age 67 years, range 53 - 80 years) with analgesic or vascular nephropathy (average GFR 54 ml/min/1.73 m2, range 30-79 ml/min/1.73 m2) given 25 mg rofecoxib daily for seven days under balanced conditions of water and sodium metabolism (salt intake 6 - 8 g/24 hours). Methods: The effect of rofecoxib on GFR measured using inulin clearance (Cin), creatinine clearance (CCr) serum cystatin C concentration (Scystatin), tubular creatinine secretion (using the ratio CCr/Cin), 24-hour urinary excretion of albumin (Ualb V) and prostaglandins (UPGE2 V and UPGFα V), basal and stimulated plasma renin activity (PRA) and serum aldosterone concentration (Saldosterone) was evaluated before and on Day 7 during rofecoxib treatment. Results: Rofecoxib did not significantly change Cin, CCr, Scystatin, CCr/Cin and U'alb V. However, UPGE2 V and UPGFα V were decreased during rofecoxib administration (p=0.059 and p=0.024, respectively). Rofecoxib attenuated the stimulated rise of PRA and Saldosterone (p=0.019 and p=0.008, respectively). Conclusions: Short-term rofecoxib administration was not associated with significant change in GFR in elderly patients with moderate chronic renal impairment under conditions of balanced salt and water metabolism despite significant attenuation of RAAS activity. Since the CCr/Cin ratio did not change in our study, we assume rofecoxib to have no influence on creatinine tubular secretion.

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KW - Renin-angiotensin-aldosterone system

KW - Rofecoxib

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