MODULE SUPPLEMENT: RENAL SYSTEM
Effects of Drugs on the Kidneys

Information on what needs to be considered related to drug therapy is provided in the section beginning with Medication and Complementary Therapies (Note: This link will open in a new browser window).

However, one important class of drugs that warrants consideration is the NSAIDs which can influence the hormonal regulation of the kidney and predispose older adults to either chronic damage or acute renal failure. Because many older adults are on NSAIDs, careful consideration of their long-term effects is extremely important.

Prostaglandins function to preserve renal blood flow/perfusion, especially in low flow states. That is, they counteract the vasoconstrictive forces in the kidney that are designed to protect glomerular filtration pressure but if excessive can cause pre-renal failure. Prostaglandins help to balance these forces.

(Adapted from Cogan, MG (1991) Fluid and Electrolytes: Physiology and Pathophysiology, 1st ed. Appleton & Lange, Norwalk, CT.)

NSAID that block prostaglandins predispose to acute renal failure, especially in low flow states like dehydration or congestive heart failure, or when older adults are subjected to dye studies since dyes serve as osmotic diuretics. Hydration evaluation becomes a critical element.