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Kidney failure is especially a risk if the patient is also concomitantly taking an ACE inhibitor (which removes angiotensin II's vasoconstriction of the efferent arteriole) and a diuretic (which drops plasma volume, and thereby RPF)—the so-called "triple whammy" effect.
The term usually refers to damage induced by excessive use of combinations of these medications, especially combinations that include phenacetin. It may also be used to describe kidney injury from any single analgesic medication. The specific kidney injuries induced by analgesics are renal papillary necrosis and chronic interstitial nephritis.
Nephrotoxicity is toxicity in the kidneys. It is a poisonous effect of some substances, both toxic chemicals and medications, on kidney function. [1] There are various forms, [2] and some drugs may affect kidney function in more than one way. Nephrotoxins are substances displaying nephrotoxicity.
Piroxicam is a nonsteroidal anti-inflammatory drug (NSAID) of the oxicam class used to relieve the symptoms of painful inflammatory conditions like arthritis. [ 4 ] [ 5 ] Piroxicam works by preventing the production of endogenous prostaglandins which are involved in the mediation of pain, stiffness, tenderness and swelling. [ 4 ]
Damage from oxygen radicals, inflammatory cells and molecules, edema, and other mechanisms mean that when oxygen flow is restored to the tissue, it can cause further damage to the kidney, potentially worsening prognosis. Despite this risk, the return of blood flow to the tissue is necessary for its survival, so clinical strategies focus on ...
Serious side effects may include heart disease, stroke, kidney problems, and stomach ulcers. [11] Use is not recommended in the third trimester of pregnancy. [11] It blocks cyclooxygenase-2 (COX-2) more than it blocks cyclooxygenase-1 (COX-1). [11] It is in the oxicam family of chemicals and is closely related to piroxicam. [11]
In terms of cause, almost any condition that involves ischemia can lead to renal papillary necrosis. A mnemonic for the causes of renal papillary necrosis is POSTCARDS: pyelonephritis, obstruction of the urogenital tract, sickle cell disease, tuberculosis, cirrhosis of the liver, analgesia/alcohol use disorder, renal vein thrombosis, diabetes mellitus, and systemic vasculitis. [3]
Samoyeds can be affected by basement membrane disease of the kidneys. It is inherited through the X chromosome and is therefore more severe in affected male dogs. Findings in male dogs include the presence of protein and glucose in the urine and the inability to concentrate urine, and progression to kidney failure by the age of 9 months and death by 16 months. [3]
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