10215647

pubmed:Citation

2

Conventional nonsteroidal anti-inflammatory drugs inhibit both cyclooxygenase (Cox) isoforms (Cox-1 and Cox-2) and may be associated with nephrotoxicity. The present study was undertaken to assess the renal effects of the specific Cox-2 inhibitor, MK-966. Healthy older adults (n = 36) were admitted to a clinical research unit, placed on a fixed sodium intake, and randomized under double-blind conditions to receive the specific Cox-2 inhibitor, MK-966 (50 mg every day), a nonspecific Cox-1/Cox-2 inhibitor, indomethacin (50 mg t.i.d.), or placebo for 2 weeks. All treatments were well tolerated. Both active regimens were associated with a transient but significant decline in urinary sodium excretion during the first 72 h of treatment. Blood pressure and body weight did not change significantly in any group. The glomerular filtration rate (GFR) was decreased by indomethacin but was not changed significantly by MK-966 treatment. Thromboxane biosynthesis by platelets was inhibited by indomethacin only. The urinary excretion of the prostacyclin metabolite 2,3-dinor-6-keto prostaglandin F1alpha was decreased by both MK-966 and indomethacin and was unchanged by placebo. Cox-2 may play a role in the systemic biosynthesis of prostacyclin in healthy humans. Selective inhibition of Cox-2 by MK-966 caused a clinically insignificant and transient retention of sodium, but no depression of GFR. Inhibition of both Cox isoforms by indomethacin caused transient sodium retention and a decline in GFR. Our data suggest that acute sodium retention by nonsteroidal anti-inflammatory drugs in healthy elderly subjects is mediated by the inhibition of Cox-2, whereas depression of GFR is due to inhibition of Cox-1.

eng

IM

MEDLINE

0022-3565

Print

NLM

735-41

pubmed-meshheading:10215647-6-Ketoprostaglandin F1 alpha, pubmed-meshheading:10215647-Aged, pubmed-meshheading:10215647-Aged, 80 and over, pubmed-meshheading:10215647-Blood Platelets, pubmed-meshheading:10215647-Cyclooxygenase 1, pubmed-meshheading:10215647-Cyclooxygenase 2, pubmed-meshheading:10215647-Cyclooxygenase 2 Inhibitors, pubmed-meshheading:10215647-Cyclooxygenase Inhibitors, pubmed-meshheading:10215647-Double-Blind Method, pubmed-meshheading:10215647-Eicosanoids, pubmed-meshheading:10215647-Female, pubmed-meshheading:10215647-Glomerular Filtration Rate, pubmed-meshheading:10215647-Hemodynamics, pubmed-meshheading:10215647-Humans, pubmed-meshheading:10215647-Indomethacin, pubmed-meshheading:10215647-Isoenzymes, pubmed-meshheading:10215647-Lactones, pubmed-meshheading:10215647-Male, pubmed-meshheading:10215647-Membrane Proteins, pubmed-meshheading:10215647-Middle Aged, pubmed-meshheading:10215647-Prostaglandin-Endoperoxide Synthases, pubmed-meshheading:10215647-Sodium, pubmed-meshheading:10215647-Sulfones, pubmed-meshheading:10215647-Thromboxane B2, pubmed-meshheading:10215647-Water-Electrolyte Balance

Effects of specific inhibition of cyclooxygenase-2 on sodium balance, hemodynamics, and vasoactive eicosanoids.

Journal Article, Clinical Trial, Research Support, U.S. Gov't, P.H.S., Randomized Controlled Trial, Research Support, Non-U.S. Gov't