Previous studies in experimental cirrhosis have shown that selective COX-2 inhibitors, such as celecoxib, do not affect renal function. By contrast, nonsteroidal anti-inflammatory drugs, including naproxen, have long been associated with acute renal failure in cirrhotic patients. To further investigate these findings, researchers, led by Joan Clria of Barcelona's Hospital Clinic, sought to compare the effects of celecoxib, naproxen and a placebo on cirrhotic patients.
They recruited 28 patients who had cirrhosis and ascites and increased activity of the renin-angiotensin system. Each one was randomly assigned to a short-term course (5 doses over 60 hours) of celecoxib, naproxen or a placebo. Results from ten of the participants were not considered in the analysis due to the discovery of hepatorenal syndrome, or lack of stable serum concentrations of clearance substances needed to calculate glomerular filtration rate (GFR) and renal plasma flow (RPF.) For the remaining patients, the researchers measured and monitored platelet and renal function, as well as the diuretic and natriuretic responses to furosemide.
Celecoxib, like the placebo, did not inhibit platelet aggregation or thromboxane B2 synthesis, while naproxen did. Celecoxib also did not affect renal function, according to RPF, GFR and serum creatinine values, w
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