Cyclooxygenases, the Kidney, and Hypertension
作者:
Hui-Fang,
Cheng Raymond,
期刊:
Hypertension: Journal of The American Heart Association
(OVID Available online 2004)
卷期:
Volume 43,
issue 3
页码: 525-530
ISSN:0194-911X
年代: 2004
出版商: OVID
关键词: COX-2;COX-1;hypertension;renin;sodium;glomerular filtration rate;kidney
数据来源: OVID
摘要:
Abstract—Selective cyclooxygenase (COX)-2 inhibitors that are in widespread clinical use were developed to avoid side effects of conventional NSAIDs, including gastrointestinal and renal toxicity. However, COX-2 is constitutively expressed in the kidney and is highly regulated in response to alterations in intravascular volume. COX-2 metabolites have been implicated in maintenance of renal blood flow, mediation of renin release, and regulation of sodium excretion. COX-2 inhibition may transiently decrease urine sodium excretion in some subjects and induce mild to moderate elevation of blood pressure. Furthermore, in conditions of relative intravascular volume depletion and/or renal hypoperfusion, interference with COX-2 activity can have deleterious effects on maintenance of renal blood flow and glomerular filtration rate. In addition to physiological regulation of COX-2 expression in the kidney, increased renal cortical COX-2 expression is seen in experimental models associated with altered renal hemodynamics and progressive renal injury (decreased renal mass, poorly controlled diabetes), and long-term treatment with selective COX-2 inhibitors ameliorates functional and structural renal damage in these conditions.
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