Are selective COX-2 inhibitors nephrotoxic?

Nonsteroidal anti-inflammatory drugs are well-known culprits in the develop ment of acute renal insufficiency in high-risk patients, The recent release of the selective cyclooxygenase-2 enzyme inhibitors for the treatment of i nflammatory diseases and pain syndromes has been associated with a clear-cu t decrease in adverse gastrointestinal effects. However, the nephrotoxic po tential of these agents in patients with prostaglandin-dependent states and chronic renal impairment is unknown. Many clinicians commonly wonder if th ese agents can be safely prescribed to such high-risk patients. We present two cases of acute renal failure complicating the course of therapy with ce lecoxib in patients with chronic renal insufficiency. (C) 2000 by the Natio nal Kidney Foundation Inc.