AVALIAÇÃO DOS EFEITOS NEFROTÓXICOS DOS ANTI-INFLAMATÓRIOS: O VALOR DOS BIOMARCADORES RENAIS NA PRÁTICA CLÍNICA

Abstract

Although anti-inflammatory drugs (NSAIDs) are widely used to relieve pain and inflammation, their prolonged use can compromise kidney function. The purpose of this study is initially to carry out a detailed analysis of the nephrotoxic effects of NSAIDs and to highlight the importance of renal biomarkers in the evaluation of these effects. Initially, the mechanisms of action of NSAIDs and how they can affect renal function will be addressed. Given the inhibition of prostaglandin synthesis in a dose-dependent manner, there may be an impairment of vasodilation of renal arterioles, culminating in ischemia and greater production of free radicals - compromising their blood flow. In addition to the pharmacological approach, conventional biomarkers used in the evaluation of renal function will be discussed, such as creatinine, urea and the estimated glomerular filtration rate, which, despite being widely used, have some interpretation limitations. Thus, it is essential to search for new renal biomarkers that can help in the early detection of renal impairment. Among the non-conventional ones, currently Cystatin C, Kidney Injury Molecule-1 (KIM-1), neutrophil gelatinase-associated lipocalin (NGAL), interleukin-18 (IL-18), N-acetyl-β-D-glucosaminidase (NAG), symmetric dimethylarginine (SDMA), Dickkopf (DKK3) as well as the accessible enzimuria technique (still little explored in the clinical area) stand out. The latter deserves a more detailed approach given its potential feasibility and low cost for health services. In conclusion, this study underscores the importance of a comprehensive approach to assessing the nephrotoxic effects of anti-inflammatory drugs. Monitoring through these biomarkers can help health professionals in making clinical decisions and implementing preventive measures to minimize the nephrotoxic impact of anti-inflammatory drugs.