Harrison's PodClass: Internal Medicine Cases and Board Prep

Ep 01: A 65-year-old with low back pain

Feb 20, 2019
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INSIGHT

NSAIDs Affect Kidney via Afferent Arteriole

  • NSAIDs like naproxen can impair kidney function by causing constriction of the afferent arteriole.
  • This happens due to inhibition of prostaglandin synthesis, reducing vasodilation and decreasing glomerular filtration rate.
INSIGHT

Vascular Effects on GFR Explained

  • Afferent arteriole constriction decreases glomerular filtration rate (GFR), while dilation increases GFR.
  • Efferent arteriole constriction increases GFR, and dilation decreases it; these actions affect kidney perfusion.
ADVICE

Careful NSAID Use in Renal Impairment

  • Use NSAIDs cautiously or avoid them in elderly patients or those with impaired renal function.
  • Consider topical agents, acetaminophen, or judicious opioid use for pain management instead.
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