Renal effects of nonsteroidal antiinflammatory drugs

Nonsteroidal antiinflammatory drugs exert their beneficial effects by inhib iting cyclooxygenase, the enzyme that converts arachidonic acid to prostagl andin E-2 and prostacyclin. These products of arachidonic acid metabolism p lay an important role in maintaining renal blood flow in patients with decr eased renal perfusion. Although uncommon, administration of NSAIDs to high- risk patients can inhibit production of vasodilatory prostaglandins and cau se acute renal failure. Therefore renal function should be monitored before and during NSAID administration.