CHRONIC NEPHROTOXICITY OF ANTIINFLAMMATORY DRUGS USED IN THE TREATMENT OF ARTHRITIS

We determined the consumption of non-steroidal anti-inflammatory drugs (NSAIDs) and the prevalence of chronic renal impairment and renal pap illary necrosis (RPN) in patients with various types of arthritis. Nin ety-four patients with chronic arthritis who had consumed more than 10 00 capsules and/or tablets of NSAIDs were studied. Renal profiles and radiological investigations such as intravenous urogram (IVU), ultraso nography (US) and computed tomography (CT) were performed to look for evidence of RPN. Twelve patients did not complete the study. Ten of th e 82 patients who had completed the study (12.2%) had radiologic evide nce of RPN. Five out of 53 patients (9.4%) with rheumatoid arthritis, three out of Il patients (27.3%) with gouty arthritis and two out of s even patients (28.6%) with osteoarthritis had RPN. Renal impairment (s erum creatinine levels of 125-451 mu mol/l) was found in 20 patients ( 24.4%). The patients had consumed 1000-26 300 capsules and/or tablets over a period ranging from 1 yr to more than 30 yr. Patients with chro nic arthritis who consume excessive amount of NSAIDs are at risk of de veloping RPN and chronic renal impairment.