Dear Dr. Spaceman,
NSAID induced renal insufficiency is due to protoglandin induced afferent arteriole vasconstriction leading to renal ischemia and acute renal insufficiency.
Please call your medical school and ask for a refund. Thanks.
Dear fatty fat fat,
You are a rough ridin' idiot.
When the circulating plasma volume becomes low for any reason (dehydrated from running a lot during a football game???), some people's renal microcirculation is kept
open only by the local
prostaglandins (PGE2 and PGI2) (NEJM 332: 647, 1995). When these people take a classic NSAID, they get vasomotor nephropathy / acute tubular necrosis, and recover in a few days. (ACE inhibitors, which prevent formation of angiotensin II, do the same thing.) Many (if not most) very-old folks given classic NSAIDs get azotemic (JAMA 264: 471, 1990; Br. Med. J. 311: 392, 1995; it happens often even today to kids in the hospital Arch. Dis. Child. 92: 524, 2007); as a matter of fact, don't give NSAID's to folks who depend on their kidneys to excrete drugs with low therapeutic indices (notably lithium).
thanks.